title: A practical approach to neurologic evaluation in the intensive care unit.
abstract: Delirium and neurologic impairment are extremely common in the intensive care setting, and their delayed identification is an important contributor to patient morbidity. Even in comatose patients, the clinical neurologic examination remains the most accurate and effective tool in assessing nervous system function. Rapid identification of neurologic deficits with a practical and easily reproducible neurologic examination is a core skill for effectively caring for critically ill patients. The purpose of this tutorial is to discuss techniques of neurologic examination and localization with an emphasis on comatose patients. Commonly encountered cases of encephalopathy and coma along with clinical pearls are presented.
authors.affiliation: Department of Neurology, University of California, San Francisco, CA. Electronic address: neel.singhal@ucsfmedctr.org.
authors.forename: Neel S
authors.initials: NS
authors.lastname: Singhal
authors.affiliation: Department of Neurology, University of California, San Francisco, CA.
authors.forename: S Andrew
authors.initials: SA
authors.lastname: Josephson
mesh_terms: D000368:Aged; D001143:Arousal; D001927:Brain Diseases / Q000150:complications / Q000175:diagnosis; D003128:Coma / Q000209:etiology*; D003221:Confusion / Q000175:diagnosis / Q000209:etiology; D003371:Cough; D016638:Critical Illness; D003693:Delirium / Q000209:etiology*; D005260:Female; D005683:Gagging / Q000502:physiology; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination / Q000379:methods*; D011597:Psychomotor Performance / Q000502:physiology; D012025:Reflex, Pupillary / Q000502:physiology; D012119:Respiration; D028761:Withholding Treatment
chemical_list: D006993:Hypnotics and Sedatives
keywords: Coma; Delirium; Encephalopathy; Neurological examination; Neurology