Neurologic Examination

  • Lisa L. Boyle


The geriatric mental health provider needs to be comfortable with the neurologic assessment to be able to distinguish between normal age-related and pathological neurologic changes. Normal age-related changes to both the central and peripheral nervous system commonly manifest with mild motor slowing and gait changes, as well as sensory changes. Given higher prevalence of neurodegenerative and other neurologic disorders with age, a focused neurologic exam is part of a comprehensive geropsychiatric assessment and provides an opportunity to identify potential comorbid neurologic disorders that may be causing or contributing to the chief behavioral or psychiatric complaint. This section will review the components of the neurologic exam in older adults.


Neurologic exam Electroencephalogram (EEG) Lumbar puncture 


  1. 1.
  2. 2.
    Harada CN, Natelson Love MC, Triebeld K. Normal Cognitive Aging. Clin Geriatr Med. 2013;29:737–52. Scholar
  3. 3.
    Galvin JE. Mental status and neurologic examination. In: Halter JB, Ouslander JG, Studenski S, High KP, Asthana S, Supiano MA, Ritchie C, editors. Hazzard's geriatric medicine and gerontology. 7th ed. New York, NY: McGraw-Hill. Accessed 4 Sept 2017.
  4. 4.
    Nichols ME, Meador KJ, Loring DW, et al. Age-related changes in the neurologic examination of healthy sexagenarians, octogenarians, and centenarians. J Geriatr Psychiatry Neurol. 1993;6:1–7.Google Scholar
  5. 5.
    Mancall EL. Neurological assessment of the elderly psychiatric patient. In: Agronin ME, Maletta GJ, editors. Principles and practice of geriatric psychiatry. 2nd ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2011. p. 77–92.Google Scholar
  6. 6.
    Walker HK. The suck, snout, palmomental, and grasp reflexes. In: Walker HK, Hall WD, Hurst JW, editors. Clinical methods: the history, physical, and laboratory examinations. 3rd ed. Boston, MA: Butterworths; 1990. p. 363–4.Google Scholar
  7. 7.
    Clarke C, Frackowiak R, Howard R, et al. The language of neurology: symptoms, signs and basic investigations. In: Clarke C, Howard R, Rossor M, Shorvon S, editors. Neurology: a queen square textbook. Oxford, UK: Blackwell Publishing Ltd; 2009. p. 75–107.CrossRefGoogle Scholar
  8. 8.
  9. 9.
    Tampi RR. Laboratory investigations. In: Tampi RR, Williamson D, editors. Fundamentals of geriatric psychiatry. New York, NY: Nova Science Publishers; 2013. p. 15–25.Google Scholar
  10. 10.
    Aminoff MJ. Electrodiagnostic studies of nervous system disorders: EEG, evoked potentials, and EMG. In: Kasper D, Fauci A, Hauser S, Longo D, Jameson J, Loscalzo J, editors. Harrison's principles of internal medicine. 19th ed. New York, NY: McGraw-Hill; 2014. Accessed 5 Sept 2017.Google Scholar
  11. 11.
  12. 12.
    Libenson MH. The abnormal EEG. In: Libenson MH, editor. Practical approach to electroencephalography. Philadelphia, PA: Saunders; 2010. p. 176–203.Google Scholar
  13. 13.
  14. 14.
    Blennow K, Dubois B, Faga AM, et al. Clinical utility of cerebrospinal fluid biomarkers in the diagnosis of early Alzheimer’s Disease. Alzheimers Dement. 2015;11:58–69. Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of PsychiatryUniversity of Wisconsin School of Medicine and Public HealthMadisonUSA
  2. 2.William S. Middleton Memorial Veterans HospitalMadisonUSA

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