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Discipline

: Paediatrics

Sub Discipline

: Pediatric

Document Title

: Paediatrics Neurological Exam Sheet

Unit

Presenting History

Key Lab Result

Neuroimaging

Neurophysiology

MENTAL STATUS

Mental Status

NormalAbnormal

Specify If Abnormal

Other Observations

If GCS Cannot Done

Development

NormalDelayed

Specify

MOTOR FUNCTION

Motor Function

NormalAbnormal

REFLEXES/BRISKNESS

REFLEXES/BRISKNESS

NormalAbnormal

MUSCLE TONE

Muscle Tone

NormalHypotonicHypertonic

Distribution

Specify

GAIT

Gait

NormalAbnormal

CRANIAL NERVES

Cranial Nerves Examination

NormalAbnormal

SENSORY

Sensory Examination

NormalAbnormal

CEREBELLAR

Cerebellar Examination

NormalAbnormal

ABNORMAL MOVEMENTS

Abnormal Movements

NoYes

Tremor:

Distribution

Specify

Dystonia:

Distribution

Choreo/ Athetosis:

Distribution

Others:

Comments

Plan

SIGNATURES

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