MS Gateway - The Multiple Sclerosis Gateway

Guide to Common Neurological Examinations

Testing Motor Function

To detect any problems with motor function (i.e. problems with motor neurons), the neurologist may begin by watching how you walk and the distance you can walk. Also noted are whether you need assistance, the type of assistance required (e.g. a stick) and the duration of assistance (e.g. intermittent or constant). Any problems with gait could possibly signify an abnormality in the pyramidal tracts, one of the main motor nerve tracts, which control voluntary movement.

Another set of tests are the motor reflex tests.

Common motor reflex tests include:
• the knee-jerk test
• the triceps reflex test
• the plantar reflex test

This is not, however, a comprehensive list.

The knee-jerk and triceps reflex test

In the knee-jerk and triceps reflex tests, the neurologist looks for brisk or exaggerated reflex responses (hyper-reflexia) and symmetry of response between left and right halve of the body, which can indicate an abnormality in the CNS.

Triceps reflex test: the doctor will tap you briskly just above the elbow on the outside of your arm. The forearm normally extends during this test

Tricep reflex test

The plantar reflex test

In the plantar response test, a normal response to scraping the lateral underside of the foot is for the big toe to flex downwards. If the toe flexes upwards, this is known as a 'positive Babinski response' and is often a sign of pyramidal dysfunction.

Plantar response test: the doctor will hold your foot with one hand and run a somewhat pointed object (e.g. a key) along the lateral length of your foot, towards your toes. Normally the big toe flexes downwards.

During reflex tests, the neurologist will also look for asymmetry, i.e. if the intensity of a reflex differs from one side of the body to the other.

Plantar response test