Specialized Exams

Neurological Exam for Clearance

A neurological examination (neuro exam) evaluates a person’s nervous system. We can do this in our office or via video telecommunication. A number of tests are available to assess a person’s motor and sensory skills, mental status, balance, coordination, reflexes, and nerve function. Though a fight doctor can perform a simple test remotely, further testing may be required if our fight doctor finds evidence of damage.

Many state commissions require a neurological exam before a fight, but these exams should be performed if you have reason to believe that there may be an underlying problem. Complaints a fighter may have after a bout might include:

• Blurry vision;
• Headaches;
• Change in behavior;
• Fatigue;
• Tingling or numbness in the arms and legs;
• A decrease in the movement of the arms and legs;
• Change in balance or coordination;
• Seizures;
• Fever;
• Tremors;
• Weakness; and
• Slurred speech.

Many of these issues are discovered during a routine physical, as damage to the nervous system can cause issues with normal daily functioning. Early detection of these neurological deficiencies can help to find the cause and lessen the chance of long-term complications. Below are some basic neurological tests that may be administered.

Balance and Motor Function

Balance can be assessed by how a person walks or stands. Another test would be to have the fighter close their eyes while standing and gently pushing the fighter on one side or another. Motor functions may be tested by pulling or pushing against the healthcare provider’s hands with their arms and legs.

Mental Status

The fighter’s level of awareness and interaction with their environment is tested with questions about the fighter’s understanding of place, time, and recent memories. We will also observe their speech to make sure it is clear and rational.

Coordination Exam

The physician may have a fighter walk along a line on the floor, tap their fingers or foot quickly, or touch their nose with their eyes closed.

Cranial Nerve Evaluation

This evaluation tests the main nerves of the brain.

• Optic Nerve (vision) – The physician may use a special light to test the patient’s eyes.
• Oculomotor, Abducens, and Trochlear Nerves (pupil size and eye movement) – The physician will have the patient follow a light with their eyes while the physician moves the light in various directions.
• Trigeminal Nerve (ability to feel inside the mouth, the face, and to move muscles involved with chewing) – The physician may touch the patient’s face at different points and watch as the patient bites down.
• Facial Nerve (face muscles and taste) – Patients may be asked to smile, show teeth, move cheeks, or identify tastes.
• Acoustic Nerve (hearing) – The physician will give a general hearing test.
• Accessory Nerve (movement of shoulders and neck) – The physician may have the patient shrug their shoulders or turn their head from side to side against mild resistance.

Hypoglossal Nerve (tongue movement) – The physician may have the patient stick out their tongue and speak.

CT Scan Review with Report

Computer Tomography (CT or CAT) scan is less detailed than an MRI, but they allow a view of the entire body. This scan uses a combination of X-Rays and a computer to create pictures that are effective in diagnosing bone injuries, cancer-related issues, or problems with the lungs.

The scan works by providing a series of images at different angles that create a final cross-section picture. Think of it as looking at a slice of bread in contrast to the whole image of the bread. The computer then stacks the slices until a detailed image is created of organs, bones, or blood vessels.

What It’s Like to Get a CT Scan

CT scans are performed in a hospital or radiology clinic. Depending on the type of scan, the doctor may have you fast a few hours before the scan. You will need to remove all metal objects from your person before the procedure.

The radiology technician who performs the CT scan will have you lie on a table inside a large, circular CT machine. The table you are lying on will slowly make its way through the scanner as X-rays rotate around your body. You will hear a buzzing or whirring noise as you move through, and you must keep still so that the images are not blurred.

Depending on how much of your body needs to be scanned, the procedure can take anywhere from a few seconds to minutes.

CT Scan with Contrast

If the fight doctor has ordered the CT scan for dense substances like bone, then a normal scan will be sufficient. However, if the scan is for soft tissues, you may be administered a concoction containing iodine or barium sulfate. This is so that the tissue shows up more clearly on the CT scan. These drugs may be administered to you through an IV, orally, or through an enema, depending on the area being scanned. You will need to drink lots of liquids after a CT scan with contrast to flush the iodine or barium from your system.

Possible Side Effects

Most of the time, any allergic reaction to the contrast materials is mild, such as an itchy rash. However, if you are prone to allergic reactions to medications, seafood, or iodine, you would tell your health care provider or fight doctor and have them monitor you after the CT Scan. Also, let your radiologist know if you have diabetes or are taking the drug Metformin so that they can inform you as to whether you should discontinue medication before the procedure.

A fight doctor can order a CT scan for you from a convenient hospital or radiology laboratory. Once we receive the results back from the scan, we will review those results and give you a report. If the scan is clear, we can clear you for this section of the fight requirements. However, if the CT scan reveals an issue, we can either suggest a course of treatment or refer you to a specialist in that field.

Book an appointment with The Fight Doctors today!