Mini Mental Status Exam (MMSE)
· Level of Consciousness
o
Ask: Year, season, day, date, month
o
What is tested?: Consciousness is impaired in damage to the
brainstem reticular formation, bilateral thalami or cerebral hemispheres
· Orientation.
o
Ask for patient’s full name, location and date
o
What is tested?: recent and long-term memory
· Memory
o
Ask patient to recall three items for a delay of 3 to 5 minutes
o
What is tested?:
§
Medial
temporal lobe and medial diencephalon
·
Damage leads
to intact immediate recall, difficulty after delay
·
Anterograde
and retrograde amnesia with sparing of earlier memories
§
loss of
memory without these time characteristics may signify damage to other areas
· Language
o
Ask patient to name pencil and watch. Read and obey the following “CLOSE
YOUR EYES”
o
What is tested?: Broca’s and Wernicke’s area
· Calculations,
right-left confusion, finger agnosia, agraphia
o
Ask patient to complete serial 7’s, WORLD backwards
o
What is tested?: dominant parietal lobe
· Apraxia
o
Ask patient to perform 3 stage command “take a paper in your hand, fold it
in half and put it on the floor”
o
Inability to
follow a motor command that is not due to a primary motor deficit or a language
impairment but caused by a deficit in higher-order planning or
conceptualization of the task
o
What is tested?:
§
localizing is
difficult because many different regions may be involved
§
commonly
present in lesions affecting the language areas and adjacent structures of the
dominant hemisphere making it difficult to prove the deficit is apraxia rather
than impaired language comprehension
§
Distinction can
often be made by asking patient to perform a task, then if they fail,
demonstrating several tasks and asking them to choose the correct one
· Neglect and
Constructions
o
What is tested?: right (nondominant) parietal lobe; much
milder neglect may occur from lesions to left parietal lobe
· Sequencing
tasks and frontal release signs
o
What is tested?: frontal lobe
· Mood
What is tested?: imbalances in neurotransmitter systems
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