Mental Status Introduction

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The mental status exam has many different versions. The structure provided here follows a fairly standard format and is organized around the anatomy of the brain. Briefly, we begin global and then go local to the left hemisphere, right hemisphere, and frontal region and finish global again. Thus, we begin with tests that involve global brain function and that determine how well we will be able to perform the rest of the exam (level of alertness, attention, and cooperation). We next ask a few standard questions that make for easy comparisons between different patients or different exams of the same patient (orientation). Next we test for limbic and global functions (memory); dominant (usually left) hemispheric language functions (language); and left parietal dysfunction (Gerstmann’s syndrome), right parietal dysfunction (neglect and constructions), and frontal dysfunction (sequencing tasks and frontal release signs). Finally, we conclude with a few more tests that are less localizing but provide important clues about brain dysfunction (apraxia, logic and abstraction, delusions, hallucinations, and mood).

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