How do you demonstrate fatigueability in a neurological examination?
Fatigue ability is a sign of muscle weariness, a sign seen in neurological disorders. It can be elicited during a neurological exam in various ways. For example ocular fatigability can be elicited by asking the patient to look up and blink repeatedly. This causes the muscle to tire and show the sign of weakness if present as ptosis or diplopia. Limb weakness can be seen by asking the patient to lift arms to 90 degrees and hold them there. Check for abnormalities if normal ask the patient to move the arm up and down at least 20 times. If there are signs of weakness the moving arm will show weakness compared to unused arm. Central or bulbar control fatigability can be tested by asking the patient to count out loud and count besides them. If the patient has weakness they will not be able to keep counting.