The Less than 5 minute cranial nerve screen

By -


Dr. Caudill and I have the privilege to teach in the Doctor of Physical Therapy program at USC, where we recently taught in the Neuropathology course.  As many of my students know, I love the cranial nerves!  There is something charming and lovely about the 12 small pairs of cranial nerves exiting from the brainstem.   More importantly, the cranial nerves provide exquisite insight for neurologic differential diagnosis.    I cannot emphasize enough the importance of completing an efficient and accurate cranial nerve screen for patients with neurologic dysfunction. 

The students in our class are now completing their final internships and I received a request from one of them to post “5 minute Cranial Nerve Screen” video that I had filmed for our class.   I put this short video together in my kitchen one afternoon with my then 4 year old daughter in order to demonstrate that a brief cranial nerve screen could be done in 5 minutes or less (I believe we completed it in 4:05).   I have to thank my daughter for being a somewhat willing test subject.  After watching the video a few times, I could definitely improve upon my technique in a few places, but the point is to get the flow and speed of the exam. 
Disclaimer: I don't normally describe facial sensory testing like “spiders crawling on the face”, so please be aware that I was using age appropriate language and instructions and modify your instructions based on your population. 

When we tried this in class, I believe we got it done in fewer than two and half minutes, so, no excuses about not having enough time in an evaluation for a cranial nerve screen! 

Here are the components of the screen included in the video:

CN II:  Visual Fields
CN II, III:  Pupillary Light Reflex
CN III, IV, VI: eye movements
CN V:  Face sensation, muscles of mastication
CN VII: Muscles of facial expression
CN VII:  Hearing screen
CN IX, X: voice quality, palate elevation, uvula deviation
CN XI: trapezius, SCM muscle testing
CN XII:  Tongue function

Click on the link for the video!

http://youtu.be/748nu85FJoc

Comments

  1. UnknownOctober 14, 2013 at 5:11 PM

    She had me scared for a second with V3 of CN V, jk. Great video and good reminder of how easy/quick it can be to perform the screen.

    ReplyDelete
  2. Julie HershbergOctober 14, 2013 at 7:02 PM

    Thanks, Jojo. So much harder to hold a 4 year olds attention--probably one of my most difficult CN screens for that reason.

    ReplyDelete

Post a Comment

Popular posts from this blog

Exercise as Medicine: Don't Forget Your Daily Dose!

By Anonymous -
Exercise is a powerful tool that has been shown in numerous studies to delay the progression of Parkinson’s disease and to even improve existing symptoms. As more research is performed and more sophisticated tools are used to analyze the effects of exercise, it is becoming more and more evident that everyone with PD should be exercising!   In an attempt to help spread the word on the benefits of exercise, we will be presenting a series of blogs that go into detail on this topic. In this initial discussion, we will introduce the top 10 reasons why individuals with Parkinson’s disease should exercise and elaborate on the #1 REASON for individuals to exercise.   Stay tuned to the upcoming blogs as we will be going into more detail and presenting the latest research regarding these 10 benefits of exercise! Here are the TOP 10 reasons why everyone with PD should get moving… 10. Exercise helps your muscles and joints loosen up so you can Move Better 9. Exercise helps yo
Read more

Move better--3 ways to stretch the hip flexors.

By -
Image
Tight hip flexors are everywhere.  But, especially for older adults and people with neurologic disorders, tightness in the hip flexors can really influence movement.  I have had clients who improve their gait speed after a good hip flexor stretch! Most people comment that they can move much more smoothly and with longer strides.  Or, even better, without back pain.   Below are 3 different ways to stretch the hip flexors and between the three of these, you should find one that is doable and feels like a good deep stretch.  Try them out just before you get moving and notice how your movement improves!   Standing hip flexor stretch- -a good one to do on the go, before a walk or other standing exercise. Kneeling hip flexor stretch.  This is my personal favorite because it isolates the muscle so well--less room for cheating. Lying down hip flexor stretch.  This version is great if it is difficult to get in the other positions or you want to do a quick stretch in bed
Read more

Top 5 Reasons to Exercise if you have Parkinson's

By -
Image
The entire [re+active] team got together last week to share our passion about exercise!  About 8000 people were reached throughout Facebook Live videos and our live exercise class.  How awesome is that!?  In our ideal world, many lives would be changed by using exercise as a potent medication to  manage the symptoms of Parkinson's Disease.  In order to make the educational videos more accessible--we wanted to put them in one place so you can have easy access.  Let's start with the Top 5 reasons to use exercise as medicine in PD:  #5: Exercise helps with constipation!  I know so many people that are on all kinds of different medications to help with constipation--let's just take the natural remedy--exercise.  Dr. Chelsea Duncan shares about how this helps.  #4: Exercise helps you sleep better.  Yikes--I know that I need this! Dr. Erin Caudill explains about the importance of sleep and how it is improved with exercise.  #3: Exercise gives you energy.  
Read more