ABSTRACT
The neurological examination is often seen as difficult and time-consuming. However, in many patients, the diagnosis will become clear as the history is taken. Indeed, in most patients presenting with headache or blackouts and in many patients with episodic dizziness there will be no abnormal physical signs and the diagnosis will be based on the history alone. The most common cause of a complete loss of smell, anosmia, is damage to one or both olfactory nerves resulting from head injury. Smell should be tested if there is suspicion of a lesion involving the anterior fossa or of dementia. The glossopharyngeal nerve supplies sensation to the posterior pharyngeal wall and tonsillar regions. The vagus nerve, apart from supplying autonomic fibres to thoracic and abdominal contents, supplies motor fibres to the muscles of the soft palate. The hypoglossal nerve innervates the muscles of the tongue. Normally the tongue is held in the floor of the mouth by activity in the tongue retractors.
