Mental Status Examination Handbook, The

Praxis and Related Cortical Movement Abnormalities

Clinicians have applied the term “praxis,” and its disorder, “apraxia,” to a wide number of conditions involving impaired motor performance. A strict and specific use of the term “apraxia” (or “dyspraxia”), however, is limited to disturbances in learned skilled movements…

Constructional, Perceptual, and Spatial Abilities

Constructional, perceptual, and spatial abilities are important, interrelated brain functions. This chapter discusses these abilities primarily in the visual modality; however, the principles and concepts apply to auditory and other modalities as well. Visual constructional tasks, such as figure copying…

Memory and Semantic Knowledge

Memory is the process of encoding, storing, and retrieving information in the brain. There are many aspects of memory. This chapter is concerned with examining the most clinically important aspects of memory, which are declarative, explicit, or conscious recollections. Patients,…

Language and Speech

Language is the usual “medium” for communication during mental status assessment. Like fundamental functions, the examiner must assess language early as disturbances can affect the rest of the examination. The first consideration is that language and speech are not the…

Arousal, Attention, and Other Fundamental Functions

Fundamental functions, or disturbances of the “sensorium,” are a prerequisite to instrumental functions. They include arousal, basic attention, “mental control,” and psychomotor speed. The multimodal aspect of orientation to time and place, although dependent on memory, is also affected by…

The Neurobehavioral History and Behavioral Observations

Obtaining a history and observing the patient are the first steps in a comprehensive mental status examination (MSX). Obtaining a history involves a skilled interview, a targeted cognitive history, and an evaluation of the patient’s personal background. Except for telephone…

Essential Behavioral Neuroanatomy

The interpretation of the mental status examination depends on an understanding of behavioral neuroanatomy. As in the rest of neurology, the examination leads to localization, followed by a differential diagnosis of disease processes. This chapter gives the essentials necessary for…

Common Clinical Disorders Affecting Mental Status Testing

It is helpful to understand how the extended mental status evaluation is altered by the commonest mental status conditions seen in the clinical setting. These can be grouped into delirium, dementia, and depression. Focal cognitive disorders are listed in the…

Principles of Mental Status Testing

This chapter aims to provide the foundation for mental status testing. The first step is to establish the goal or purpose for assessing cognition. This guides the decision on what level of examination is needed and whether to refer for…