Amnesia physical examination
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Zehra Malik, M.B.B.S[2]
Overview
Patients with amnesia may have variable general appearance depending on the underlying cause of memory loss.
Physical Examination
Patients with amnesia may have variable general appearance depending on the underlying cause of memory loss.
Appearance of the Patient
- Patients with memory loss could appear completely normal or may present with cognitive impairment, signs of head trauma, alcohol abuse.
Vital Signs
- It is crucial to assess vital signs repeatedly and compare Glasgow Coma Scale scores in intervals for patients with recent history of head trauma with or without loss of consciousness.[1]
- Vital Signs should include assessment of heart rate, blood pressure, oxygen saturation, and temperature.
Skin
- Skin examination of patients with memory loss is usually normal, signs of head trauma should be assessed.
HEENT
- HEENT examination of patients with amnesia is usually normal. Abnormalities to be observed includes:
- Evidence of trauma
- Nystagmus in Korsakoff's syndrome
- Ophthalmoscope examination may be abnormal with findings of papilledema in case of head trauma.
Neck
- Neck examination of patients with amnesia is usually normal.
Lungs
- Pulmonary examination of patients with amnesia is usually normal.
Heart
- Cardiovascular examination of patients with amnesia is usually normal.
Abdomen
- Abdominal examination of patients with amnesia is usually normal.
Back
- Back examination of patients with amnesia is usually normal.
Genitourinary
- Genitourinary examination of patients with amnesia is usually normal.
Neuromuscular
- Neuromuscular examination of patients with amnesia depends on the underlying cause.
- Patient's orientation to persons, place, and time should be determined.
- Altered mental status
- Glasgow coma scale
- Clonus may be present
- Hyperreflexia / hyporeflexia / areflexia
- Positive (abnormal) Babinski / plantar reflex unilaterally/bilaterally
- Muscle rigidity
- Proximal/distal muscle weakness unilaterally/bilaterally
- ____ (finding) suggestive of cranial nerve ___ (roman numerical) deficit (e.g. Dilated pupils suggestive of CN III deficit)
- Unilateral/bilateral upper/lower extremity weakness
- Unilateral/bilateral sensory loss in the upper/lower extremity
- Positive straight leg raise test
- Abnormal gait (describe gait: e.g. ataxic (cerebellar) gait / steppage gait / waddling gait / choeiform gait / Parkinsonian gait / sensory gait)
- Positive/negative Trendelenburg sign
- Unilateral/bilateral tremor (describe tremor, e.g. at rest, pill-rolling)
- Normal finger-to-nose test / Dysmetria
- Absent/present dysdiadochokinesia (palm tapping test)
Extremities
- Extremities examination of patients with amnesia is usually normal.