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MKSAP Neurology Review

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Stupor and Coma<br />

• FOCAL DEFICIT = Brain is at fault<br />

• LOCALIZE the lesion<br />

– Examine ALL cranial nerve reflexes:<br />

• Pupillary<br />

• Blink<br />

• Oculocephalic [NOT Doll’s eyes]<br />

• Pharyngeal [NOT gag]<br />

– Posturing?<br />

• Decorticate or arm flexion = above red nucleus<br />

• Decerebrate or arm extension = below red nucleus

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