When does one do a full head to toe neurological exam?

[HeyJey]

Hello. I am doing my Neurology rotation in an outpatient clinic. I noticed that even for new patients there doesn't seem to be that much of doing any sort of neurological examination outside of "close your eyes and touch your nose," "walk this line with one foot in front of the other," "who's the current and past president," and a few other tasks.
My impression was that neurologists do a complete neurological exam for new patients and take very long detailed histories.
Under what conditions and in what settings do full neurological exams and long histories get performed?
Thank you doctors.

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[neurodoc]

As you are in your Neuro rotation you will have a great opportunity to ask your teachers that excellent question! I say this sincerely and without any sarcasm at all. The two most important things med students should learn in their clinical neurology rotation are: 1) the neurologic method of diagnosis; and, 2) how to perform a "complete" neurologic examination so as to arrive at a diagnosis by the neurological method. Eventually neurologists develop abbreviated exam protocols, e.g. doing exams "focused" on the patient's complaints, but it's important to know what the complete exam would involve before you start leaving out parts of it.

BTW, a really good book for med students is The Four-Minute Neurologic Exam, by Stephen Goldberg. I don't know if it's still in print, but if it is you'll find it extremely comprehensive for its size (only about 50 pages).

 

[iBS1972]

I figure you've already finished your rotation. If so, please share your answer. I completed my neuro rotation a few months back and didn't learn as much as I wanted to, fault of my own.

I'd imagine that new and relapsing MS patients would be indications for a complete neuro exam?

Thanks neurodoc for the recommendation.