Tips for Conducting a Virtual Neurologic Exam

This transcript has been edited for clarity.

Stephen Krieger, MD: Hi. I'm Dr Stephen Krieger, a neurologist at the Corinne Goldsmith Dickinson Center for Multiple Sclerosis at Mount Sinai in New York. I'm here today with my collaborator Erin to show you how we do a neurologic examination over video. Erin, thanks so much for joining us.

Erin Staker: Thanks for having me.

Krieger: Neurology, of course, is a very hands-on field. We prioritize the neurologic examination to give us crucial clinical information about our patients. Many of us have been doing this remotely by virtual health throughout the months of 2020. We've developed techniques to try to accomplish many of the things that we need to do in the neurologic exam over video, which is a challenge because we don't have the use of our usual tools at our disposal, like tuning forks and reflex hammers. But we have come up with ways of filling that in with certain other props that I think provide useful information.

When I set up a video visit with one of my patients, I'll ask them to have three props on hand: a hair tie or a rubber band to look at upper-extremity strength, a cell phone with a flashlight that we'll use for cranial nerves and pupil responses, and something cold that came out of the fridge recently to look for temperature sensations.