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PREFLIGHT NEUROLOGICAL EVALUATION FORM (Form must be completed by a neurologist or neurosurgeon)NAME: AGE: HANDED:DATE: RIGHT LEFT YEARS BOXING: FIGHT RECORD: LAST FIGHT: OCCUPATION: COMMENTS: NEUROLOGICAL
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How to fill out neurological evaluation
How to fill out neurological evaluation
01
Begin by reviewing the patient's medical history and any relevant imaging or lab test results.
02
Gather the necessary evaluation tools, such as a reflex hammer, tuning fork, and sensory testing materials.
03
Start with a general observation of the patient's appearance, behavior, and gait.
04
Perform a thorough cranial nerve examination, assessing functions like vision, hearing, and facial movements.
05
Proceed to assess motor function by checking muscle strength, tone, and coordination.
06
Evaluate sensory function by testing different modalities such as light touch, pain, temperature, and vibration.
07
Test deep tendon reflexes using the reflex hammer, paying attention to any abnormal responses.
08
Assess coordination and balance through tests like finger-to-nose and heel-to-shin movements.
09
Perform specific tests for specific neurological conditions, if necessary.
10
Record all findings accurately and interpret them in the context of the patient's overall clinical picture.
Who needs neurological evaluation?
01
Neurological evaluation is recommended for individuals who experience symptoms or conditions that may suggest a problem with the nervous system.
02
This can include people with chronic migraines, seizures, multiple sclerosis, Parkinson's disease, neuropathy, or other neurological disorders.
03
It is also necessary for anyone who has suffered a head injury, stroke, or spinal cord injury.
04
Additionally, individuals with cognitive or developmental issues may benefit from a neurological evaluation.
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