General inspection

The general examination in the neurological examination should include:

• abnormal posture, for example, in an upper motor neurone lesion with flexion of the upper limb - arm pronated and adducted - and extension of the lower limb
• muscle wasting - this indicates primary muscle disease, denervated muscle, or disuse atrophy - when looking for wasting compare both sides and try to work out what pattern of muscle wasting, for example proximal, distal, generalised, symmetrical
• abnormal movements, such as athetosis or tremor
• skin - herpes zoster, neurofibromatosis, segmental distribution of angiomata - associated with spinal astrocytoma and syringomyelia