NEURORESCUE EXAMINATION

Yes. Your examination consists of a number of procedures that are designed to challenge a series of neurological functions and reflexes. These procedures involve tests that are performed in every neurological examination.

They also include test variations that give us a more precise view of the level of function in your systems, by challenging them to the point where they begin to show fatigue. These procedures do not lead to any lasting symptoms, and show us what we need to do to restore your highest level of neurological function.

A standard neurological examination is focused on identifying the presence of pathological processes such as strokes, tumors, injuries, and neurodegenerative diseases. It does so by looking for the presence of pathological reflexes, which reveal the presence of damaged or destroyed tissue. When combined with laboratory findings and imaging, this enables proper identification of the pathology, and where possible, dictates interventions that can slow or halt the progression of the pathological process.

Our examination begins with evaluation of pathological reflexes, but does not stop there. We also focus intently on the level of function present in remaining systems. We do not simply decide that something works, and move on. Rather, we evaluate every system according to three metrics: time to summation, intensity of summation, and time to fatigue. We don’t just want to know if a system works, we want to see how well it works, under what conditions it may fatigue and fail, and how well it works with other systems. It is important to understand that your ability to have a happy and successful life is not dictated by aspects of your nervous system that have been damaged or lost, but by the level of function of your systems that remain. By focusing our attention on these systems, we can gain insight into how to maximize their functional expression, so we can get you back to living your best life.

Your neurological examination shows us the level of function in every relevant system of your neuraxis. These include:

Sensory systems: These include conscious sensation, such as vision, touch, smell, and hearing. They also include an unconscious sensation known as proprioception, the process by which your brain learns of the stresses on muscles and joints. Your various sensory systems are processed in different regions of the brain. Deficits in sensory processing can show us how well these brain regions are functioning.  

Autonomic systems: Your autonomic nervous system is responsible for controlling critical unconscious functions such as heart rate, blood pressure, respiration, and digestion. These systems live in the brainstem, but have their function influenced by pathways from many brain and cerebellar regions. Problems with the autonomic system are seen in a wide range of neurological disorders. 

Motor systems: The ability to move in a smooth and coordinated fashion requires proper functional integration of the frontal and parietal lobes, as well as the cerebellum, basal ganglia, brainstem, spinal cord, and peripheral nervous systems. Problems in any of these areas show characteristic patterns of motor dysfunction, which can give us insight into how to properly rehabilitate your motor function. 

Oculomotor systems: The ability to properly control and coordinate eye movements is a foundational aspect of our ability to properly interact with the world. In order to properly respond to the environment, you must first accurately localize yourself within it. You create much of your environment through visual input, which requires a number of visual reflexes to be functioning appropriately.  Impaired eye movements are found at the heart of a wide variety of neurological conditions. 

Vestibular systems: The brain also relies on the vestibular system to make sense of where it is in the world. This system consists of inner ear receptors that perceive gravity and head movement, and the brainstem, cerebellar, and brain regions that process inner ear input.  Problems with the vestibular system are found in everything from dizziness and vertigo to brain injuries, neurodegenerative conditions, and cognitive challenges.

Limbic systems: Your limbic system dictates your emotional state. It is found in the medial wall of the brain, and governs our drives and motivation. It also influences cognitive, autonomic, and motor system function. Limbic dysfunction impedes neurological recovery, and must be addressed in any successful process of rehabilitation.

Nociceptive systems: Nociception is the sensory input that we generally think of as pain. Pain is not a sensation, it is an experience involving both perception and emotion. Nociception involves small fibers from the peripheral nervous system, as well as structures in the spinal cord, brainstem, and brain that process and modulate this input. Problems with central nociceptive processing are seen in most chronic pain states.

Cognitive systems: Cognition and mental status involve the entire brain, but are largely governed by regions of the frontal lobes. These regions express their function in cognitive tasks, but also through particular classes of eye movements. Our examination shows us which of these systems may be struggling, and reveals strategies to aid in their rehabilitation.

There are specific therapies and rehabilitation strategies to address the dysfunction we may find in every part of our examination. These strategies will be different in every case, and driven entirely by your examination findings. The extent to which they will succeed will depend on the severity of your condition and the viability of your remaining neurological systems.

It is important to understand that once neurons have been lost to an injury of disease process, there is nothing that can be done to bring them back. In most neurodegenerative diseases, therapies to stop or reverse the progression of the disease have yet to be developed. By focusing on the function of your remaining systems, we can still develop strategies to improve your quality of function, and thus help get you back to living the life you deserve.