Neuro OSCE

Case 1:

Somebody complains of double vision when looking up, how do you know its true?

Check to see if patient still has the double vision when one of their eyes is covered.

What are the muscles that allow you to look up?

Superior rectus and inferior oblique

How do you test these muscles?

Superior rectus: Have the patient look to the side and then look up
Inferior oblique: Have the patient look to the center and then look up

Case 2:

Somebody has a non-dominant lesion of the brain, what are the signs?

Neglect: Patients tend to be less aware (or completely unaware) of objections or actions in
one side of the world (usually the left)
Visuospatial spatial deficits such as prosopagnosia (inability to recognize faces)
Understanding of/use of prosody is affected:
Patients may have difficulty applying the proper inflection to their own speech output and
may sound monotone
Patients may have difficulty understanding the speech inflections of those speaking to them
Anosognosia: Patient may have a tendency to be unaware of their deficits

3 tests to check for non-dominant lesions of the brain

Line bisection to test for neglect

Extinction to double simultaneous stimulation, which may be the only finding seen in patients
w/ the mildest form
Clock draw to test for neglect and construction