Neurological screening

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Definition

• A specific type of neurologic examination for early detection of disease(s) and/or disorder(s).

What is neurological screening examination?

• A neurological examination involves a thorough history, including family history, and a detailed neurological examination to assesses motor and sensory skills, hearing and speech, vision, coordination, and balance. It may also test mental status, mood, and behavior.

Neuro exam

• The examination uses tools such as a tuning fork, flashlight, reflex hammer, and a tool for examining the eye.
• The results of the neurological examination and the patient’s history are used to determine a list of possibilities, known as the differential diagnosis, that help determine which additional diagnostic tests and procedures are needed.

Neuro screening tests

• Laboratory screening tests of blood, urine, or other body fluids may help doctors diagnose disease, understand disease severity, and monitor levels of therapeutic drugs.

Neurological Exam

Blood tests

• Certain tests, ordered by the physician as part of a regular check-up, provide general information, while others are used to identify specific health concerns.

Blood tests can provide evidence for infections, toxins, clotting disorders, or antibodies that signal the presence of an autoimmune disease. Genetic testing of DNA extracted from cells in the blood or saliva can be used to diagnose hereditary disorders. Blood tests can monitor levels of therapeutic drugs used to treat epilepsy and other neurological disorders.

CSF tests

• Analysis of the fluid that surrounds the brain and spinal cord called spinal fluid obtained via a lumbar puncture can detect meningitis, encephalitis, acute and chronic inflammation, viral infections, multiple sclerosis, and certain neurodegenerative disorders.

Metabolic testing

• Chemical and metabolic testing of the blood can indicate some muscle disorders, protein or fat-related disorders that affect the brain and inborn errors of metabolism.

Urine tests

• Analyzing urine samples can reveal toxins, abnormal metabolic substances, proteins that cause disease, or signs of certain infections.

Genetic testing

• Genetic testing of people with a family history of a neurological disease can determine if they are carrying one of the genes known to cause the disorder.
• Genetic counseling may be recommended for patients, or parents of children being tested, to help them understand the purpose of the tests and what the results could mean.
• Genetic testing that is used for diagnosis or treatment should be done in a laboratory that has been certified for clinical testing. Clinical testing can look for mutations in specific genes or in certain regions of several genes.

Prenatal testing

• Prenatal genetic testing can identify many neurological disorders and genetic abnormalities in utero (while the child is inside the mother’s womb).
• The mother’s blood can be screened for abnormalities that suggest a risk for a genetic disorder. Cell-free DNA from the mother’s blood can also be used to look for Down syndrome and some chromosomal disorders.

Spina bifida ultrasound

Triple scan

• Doctors may also use a type of blood test called a triple screen in order to identify some genetic disorders, including trisomies (disorders such as Down syndrome in which the fetus has an extra chromosome) in an unborn baby.
• A blood sample is taken from a pregnant woman and tested for three substances: alpha-fetoprotein, human chorionic gonadotropin, and estriol. The test is performed between the 15th and 20th week of pregnancy.
• It usually takes several days to receive results from a triple screen.
• Abnormal results of a triple screen may indicate a possible problem such as spina bifida (the incomplete development of the brain, spinal cord, or the cord’s protective coverings) or a chromosome abnormality. However, the test has many false positive results, so additional testing is needed to confirm if there is a problem.

Amniocentesis

• Amniocentesis is usually done at 14-16 weeks of pregnancy. It tests a sample of the amniotic fluid in the womb for genetic defects (the cells found in the fluid and the fetus have the same DNA). Under local anesthesia, a thin needle is inserted through the woman’s abdomen and into the womb.
• About 20 milliliters of fluid (roughly 4 teaspoons) is withdrawn and sent to a lab for evaluation which can take 1-2 weeks.

Chorionic villus sampling

• Chorionic villus sampling is performed by removing and testing a very small sample of the placenta during early pregnancy. The sample, which contains the same DNA as the fetus, is removed by catheter or fine needle inserted through the cervix or by a fine needle inserted through the abdomen. Results are usually available within 2 weeks.

Brain scans

• Brain scans include several types of imaging techniques used to diagnose tumors, blood vessel malformations, stroke, injuries, abnormal brain development, and hemorrhage in the brain. Types of brain scans include computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), and single proton emission (SPECT) scans.
• Computed tomography (CT scan) uses X-rays to produce two-dimensional images of organs, bones, and tissues.
• Magnetic resonance imaging (MRI) uses computer-generated radio waves and a powerful magnetic field to produce detailed images of body tissues.

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