Introduces self
0
1

Confirms name & age of patient
0
1

Explains & gains consent
0
1

Washes hands
0
1

Exposes & positions patient
0
1

Asks if patient is in pain
0
1

General inspection: asymmetry, ptosis, tremor, scars (particularly behind ear)
0
1

Asks patient if they have experienced any numbness/paraesthesia of face
0
1

Tests light touch in 3 divisions of V nerve
0
1

Offers to test sharp touch via pin prick
0
1

Washes hands
0
1

Inspects muscles of mastication for weakness or fasciculations
0
1

Palpates bulk of masseters and temporalis. Tests strength of Pterygoids
0
1

Offers to do corneal reflex, jaw jerk reflex
0
1

Inspects for asymmetric wrinkling of the forehead
0
1

Asks patient to raise eyebrows, close eyes against resistance
0
1

Asks patient puff out cheeks against resistance and show their teeth
0
1

Asks about changes in taste and hearing. Offers formal testing of taste
0
1

Performs gross hearing assessment by whispering in one ear whilst distracting the other
0
1

Offers to do Rinnie's and Webbers test and auroscopy
0
1

Thanks patient and offers help to redress
0
1

Washes hands
0
1

Requests a full neurological exam for completion of exam
0
1

Summarises appropriately with only key findings
0
1

Offers appropriate differential diagnoses
0
1

Patient global score
0
1
2
Potential differentials
  • CN5 - abnormalities in sensation can be caused by facial trauma or local cancer invasion
  • CN7 - Bell's palsy if lower motor neurone lesion (forehead muscles affected)
    • Differential Ramsay Hunt syndrome for varicella zoster
    • Acoustic neuroma particularly if CN8 also affected
    • Stroke if forehead muscles spared (upper motor neurone lesion)