The Nervous System
In an objective structured clinical examination (OSCE), one can expect to have at least one station from the nervous system. Usually it is a history taking along with physical examination station. One can also expect to be asked to perform a detailed physical examination only. Commonly asked tasks are cranial nerve examination, motor/sensory system examination, or cerebellar system examination. In these stations it is important to analyze the doorway information to customize the physical examination. It will be difficult to complete all the steps of a particular nervous system examination in a limited time frame. A lot of practice is required before the actual examination to complete these stations in the given time. For a history and physical examination station, only the most important and relevant questions should be asked, and sufficient time should be allocated to the physical examination and for a wrap-up in the end.
This chapter outlines common nervous system-related topics important for the OSCE. An overview of the pattern of history taking required for nervous system stations is given at the start of the chapter. Physical examination checklists are given for a quick review. Nervous system examination does need some gadgets such as a hammer, a measuring tape, cotton wool, a pin, and a tuning fork. Please check with your examination guidelines if these will be provided in the examination room, or you may need to bring these. If you will be bringing your own gadgets, then make sure to take these with you after finishing each examination.
KeywordsNervous system Upper limbs Lower limbs Cerebellar syndromes Cranial nerves Stroke Transient ischemic attack (TIA) Unilateral facial weakness Bell’s palsy Headache Migraine Meningitis Seizures Dizziness Benign paroxysmal positional vertigo Unresponsive patient Parkinson’s disease Falls Intoxication
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