NeuroPocket · NSIG

Lesion Localizer

Tap the findings you see. NeuroPocket ranks the classic localization patterns that fit best, and shows which findings support or argue against each one.

Most likely patterns

Patterns follow standard neuroanatomical localization teaching. Real patients often have mixed or atypical findings.

NIH Stroke Scale

Score each item as you examine. Record what the patient does, not what you think they can do. Score the first attempt.

Based on the NIH Stroke Scale (National Institute of Neurological Disorders and Stroke). Severity bands are commonly used groupings, not strict cut-offs.

Glasgow Coma Scale

Pick the best response in each category. Report the components (e.g. E3 V4 M6) as well as the total.

Based on the Glasgow Coma Scale (Teasdale & Jennett, 1974; updated terminology from glasgowcomascale.org). Severity bands refer to traumatic brain injury.

Exam Companion

A step-by-step checklist for a complete neurological exam. Tick as you go, so you don't miss anything on the ward.

0 / 0

MRC muscle power scale

5	Normal power
4	Active movement against gravity and some resistance
3	Active movement against gravity, but not against resistance
2	Active movement with gravity eliminated
1	Flicker or trace of contraction
0	No contraction

Reflex grading

4+	Very brisk, with sustained clonus
3+	Brisker than normal, may spread to other muscles
2+	Normal
1+	Diminished, or present only with reinforcement
0	Absent, even with reinforcement

Upper motor neuron: increased tone, brisk reflexes, upgoing plantar. Lower motor neuron: wasting, fasciculations, reduced tone and reflexes.

Root Finder

Tap a nerve root to see its key sensory point, key muscle and reflex. Useful for radiculopathy and spinal cord exams.

Key sensory points

Where to test each dermatome.

Level	Key sensory point

Key sensory points and key muscles follow the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI). Dermatomes vary between individuals and overlap.

Red Flags

The things you never want to miss. Learn them, recognize them, and escalate early.

Stroke: BE FAST

BBalanceSudden loss of balance or coordination

EEyesSudden loss of vision or double vision

FFaceFacial droop on one side

AArmWeakness or numbness in one arm or leg

SSpeechSlurred speech or trouble finding or understanding words

TTimeNote the time the symptoms started (last known well) and call for help immediately

Time is brain. In the community, call emergency services right away (997 in Saudi Arabia). On the ward, activate your hospital's stroke code and escalate to a senior.

Headache red flags: SNOOP

SSystemicFever, weight loss, or risk factors such as cancer, HIV or immunosuppression

NNeurologicalFocal deficits, confusion, reduced consciousness, papilledema or seizures

OOnsetSudden, "thunderclap": worst headache, peaking within a minute

OOlderNew headache after age 50

PPattern changeProgressive, positional, triggered by coughing or straining, or new in pregnancy

A thunderclap headache needs urgent assessment for subarachnoid hemorrhage.

Seizure first aid

Time it from the start.
Keep them safe: move hard objects away and cushion the head.
Do not restrain them or put anything in their mouth.
Turn them on their side once the jerking stops, and stay with them until they're fully aware.

Get emergency help if the seizure lasts 5 minutes or more, seizures repeat without recovery in between, it's a first seizure, the person is injured, pregnant or has trouble breathing, or they don't wake up afterwards. A seizure lasting 5 minutes or more is treated as status epilepticus.

Spinal cord compression & cauda equina

New bladder or bowel dysfunction (retention, incontinence)
Saddle anesthesia (numbness around the perineum)
Bilateral leg weakness or numbness
Back pain with cancer history, fever or significant trauma

These need same-day senior review and urgent imaging.

BE FAST and SNOOP are widely used teaching mnemonics. Seizure first-aid guidance is adapted from public epilepsy first-aid recommendations.