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Higher mental function

Authoring team

The following are points in a neurological examination that relate to higher mental function:

  • right or left handedness

  • level of arousal:
    • awake and alert
    • drowsy
    • stuporous
    • comatose
    • the Glasgow coma score may be used

  • orientation: in person, place, date

  • commands:
    • one step midline - "stick out your tongue"
    • one step limb - "show three fingers"
    • two step - "point to the ceiling and floor"
    • three step - "take paper, fold, put on floor"
    • crossing the midline - "touch left ear with right finger"

  • memory:
    • 3 objects - immediate recall, e.g. Birmingham, Winston Churchill, shoe.

  • cognitive functioning- spell WORLD forwards and backwards, proverb interpretation, digit span, maths.

  • language & free speech:
    • name some objects, e.g. finger, watch
    • repetition "no ifs ands or buts" - tests Broca's area

  • memory - recall the three objects

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