OSCE Practical Questions

Question 1

What is the purpose of the neurological examination?

Answer 1

To localise where in the nervous system the problem is (upper vs lower motor neuron lesion)

Question 2

What are the signs of upper motor neuron lesions?

Answer 2

• increased tone (spasticity/rigidity)
• increased/brisk refleces
• flexors weaker than extensors in lower limb (opposite in upper)
• positive Babinski sign

Question 3

What are the signs of lower motor neuron lesions?

Answer 3

• muscle wasting and fasciculations
• decreased/normal tone
• proximal weakness = muscle disease
• distal weakness = peripheral neuropathy
• normal/mute Babinski reflex

Question 4

What are the 5 main things you are looking for on general/close inspection during a neurological examination?

Answer 4

SWIFT

• scarring
• wasting of the muscles
• involuntary movements
• fasciculations
• tremor

Question 5

What is the Romberg’s test for in the neurological examination of the lower limbs?

Answer 5

• to test for sensory ataxia
• positive test shows deficit in either proprioceptive or vestibular function
• falling without correction = positive test