1. The past history
The examination begins in the consulting room. You describe your problems. The closest possible description of the symptoms (What exactly do you feel?) and the time sequence (…since when, …how often?) are important for the person conducting the examination. You will be asked to undress: you can usually keep your underwear on but must remove your socks/stockings. This is necessary for the full neurological and psychiatric examination that is always carried out when you appear for the first time, even if you only have problems with, say, your head or your hand.
The neurological and psychiatric examination is supplemented by specific targeted questions in accordance with the principles of traditional Chinese diagnosis, including the lingual findings. An impression is gained of the overall condition of the patient.
2. The physical results
You will first be examined standing up. The sense of balance and the coordination of movement are tested. Then I ask you to lie down. First of all, with you lying in a relaxed supine position, I carry out an examination of the 12 cranial nerves, including pathological eye movement patterns, the feeling in the face, the muscular supply to the head and the sensitivity of the neck. This is followed by the tests of the reflexes and the surface and depth sensitivity of the arms and legs. In the case of back problems or symptoms in the arms and legs, for example, tests of the muscle functions are carried out. The examination of each and every muscle on the arms and legs allows a diagnostic conclusion to be drawn about the condition of the assigned spinal nerve roots. This is indispensable, particularly for the neurological diagnosis of intervertebral disc disorders. In the case of intervertebral disc prolapses, the further therapeutic procedure is dependent on the results of the first detailed neurological examination. This forms the basis of the decision on whether the patient should be treated conservatively (acupuncture, physiatrics and physiotherapy) or surgically.
Finally, the Babinski symptom is examined by scratching rather unpleasantly on the soles of the feet.