Kuliah Pasca MMSE Dan Strub & Black

7/23/2019 Kuliah Pasca MMSE Dan Strub & Black

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THE MENTAL STATUSTHE MENTAL STATUS

EXAMINATIONEXAMINATION

IN NEUROLOGYIN NEUROLOGY

dr.Hj.Yustiani Dikot, Sp.S!"dr.Hj.Yustiani Dikot, Sp.S!"

D#part$#nt o% N#uro&o'(D#part$#nt o% N#uro&o'(

Hasan Sadikin Hospita&Hasan Sadikin Hospita&

)andun')andun'



GOALS O* MENTAL STATUSGOALS O* MENTAL STATUS

EXAMINATIONSEXAMINATIONS Ear&( d#t#+tion o% or'ani+a&&( as#dEar&( d#t#+tion o% or'ani+a&&( as#d

#-aiora& +-an'#s.#-aiora& +-an'#s. S+r##nin' to d#t#r$in# t-# n##d %or aS+r##nin' to d#t#r$in# t-# n##d %or a

+o$pr#-#nsi# n#urops(+-o&o'i+a&+o$pr#-#nsi# n#urops(+-o&o'i+a&ass#ss$#nt.ass#ss$#nt.

A+/uisition o% data +ontriutin' to t-# A+/uisition o% data +ontriutin' to t-#

dia'nosis o% ot- '#n#ra& n#uro#-aiora&dia'nosis o% ot- '#n#ra& n#uro#-aiora&s(ndro$#s and sp#+i%i+ n#uro#-aiora&s(ndro$#s and sp#+i%i+ n#uro#-aiora&s(ndro$#s.s(ndro$#s.



MENTAL STATUS S0REENINGMENTAL STATUS S0REENING

1ati#nts initia&&( pr#s#nt 2it- a'u#1ati#nts initia&&( pr#s#nt 2it- a'u##-aiora& +o$p&aints.#-aiora& +o$p&aints.

1ati#nts 2it- possii&it( o% or'ani+ rain1ati#nts 2it- possii&it( o% or'ani+ raindis#as#dis#as#

1ati#nts 2it- +o$p&aints su+- as $#$or(31ati#nts 2it- +o$p&aints su+- as $#$or(3pro&#$s ,di%%i+u&t( in +on+#ntration,pro&#$s ,di%%i+u&t( in +on+#ntration,

d#+&inin' int#r#st in %a$i&( or 2orks ord#+&inin' int#r#st in %a$i&( or 2orks orp-(si+a& +o$p&aints 2it-out or'ani+p-(si+a& +o$p&aints 2it-out or'ani+#tio&o'(#tio&o'(



Histor(4Histor(4 1ati#nt5s pr#$orid &##& o% %un+tionin'.1ati#nt5s pr#$orid &##& o% %un+tionin'. Data to #sta&is- t-# pr#s#n+# or as#n+# o%Data to #sta&is- t-# pr#s#n+# or as#n+# o%

#-aiora& indi+ators o% or'ani+ d(s%un+tion.#-aiora& indi+ators o% or'ani+ d(s%un+tion.

0onsid#ration o% pr##6istin' or +o#6istin'0onsid#ration o% pr##6istin' or +o#6istin'#$otiona& or #-aiora& pro&#$s.#$otiona& or #-aiora& pro&#$s.

T-# pati#nt5s '#n#ra& $#di+a& +ondition.T-# pati#nt5s '#n#ra& $#di+a& +ondition. So+ia&, #du+ation, o+ation and -oi#sSo+ia&, #du+ation, o+ation and -oi#s *a$i&( $#di+a& -istor(, #sp#+ia&&( o%*a$i&( $#di+a& -istor(, #sp#+ia&&( o%

n#uro&o'i+a& and ps(+-iatri+ dis#as#sn#uro&o'i+a& and ps(+-iatri+ dis#as#s



MENTAL STATE EXAMINATIONMENTAL STATE EXAMINATION

)#-aiora& os#rations)#-aiora& os#rations

L##& o% +ons+iousn#ss and att#ntion.L##& o% +ons+iousn#ss and att#ntion.

Lan'ua'#.Lan'ua'#.

M#$or(.M#$or(.

0onstru+tiona& ai&it(.0onstru+tiona& ai&it(.

Hi'-#r +orti+a& %un+tions4Hi'-#r +orti+a& %un+tions4 Astra+t tasks. Astra+t tasks.

0a&+u&ation.0a&+u&ation.

Insi'-t and 7ud'#$#nt.Insi'-t and 7ud'#$#nt.

S i



S+r##nin' 4S+r##nin' 4

Mini M#nta& Stat# E6a$inationMini M#nta& Stat# E6a$ination



M#nta& Status E6a$inationM#nta& Status E6a$ination

R#+ordin' *or$ Stru 8 )&a+k"R#+ordin' *or$ Stru 8 )&a+k"

PATIENT INFORMATIONPATIENT INFORMATION

1ati#nt Na$#1ati#nt Na$# Addr#ss Addr#ss

Dat# o% irt-Dat# o% irt- A'# A'# Edu+ationEdu+ation Hand#dn#ssHand#dn#ss

O++upationO++upation M#di+a& dia'nosisM#di+a& dia'nosis H#$ip&#'iaH#$ip&#'ia H#$ianopsiaH#$ianopsia



I.I. HISTORY AND )EHA9IORALHISTORY AND )EHA9IORALO)SER9ATIONSO)SER9ATIONS

Histor( o% #-aior +-an'#, $#$or( di%%i+u&ti#s,Histor( o% #-aior +-an'#, $#$or( di%%i+u&ti#s,i:arr# #-aior, +-an'#s in 2ork -aits #t+.i:arr# #-aior, +-an'#s in 2ork -aits #t+.

1-(si+a& app#aran+#1-(si+a& app#aran+#

E$otiona& statusE$otiona& status

*ronta& &o# t#st r#su&ts*ronta& &o# t#st r#su&ts D#nia& or n#'&#+tD#nia& or n#'&#+t



II.II. LE9EL O* 0ONS0IOUSNESSLE9EL O* 0ONS0IOUSNESS

Rat#4 A&#rt;;. L#t-ar'i+ ;.. Stupor ;..0o$aRat#4 A&#rt;;. L#t-ar'i+ ;.. Stupor ;..0o$a

D#s+ri# sti$u&us n#+#ssar( to arous# pati#ntD#s+ri# sti$u&us n#+#ssar( to arous# pati#nt



III.III. ATTENTION ATTENTION

Os#ration o% pati#nt durin' #6a$inationOs#ration o% pati#nt durin' #6a$ination

Di'it r#p#titionDi'it r#p#tition

9i'i&an+#9i'i&an+# pati#nt taps t-# ta&# 2-#n##r -# -#arspati#nt taps t-# ta&# 2-#n##r -# -#ars

<A=<A=

Uni&at#ra& inatt#ntionUni&at#ra& inatt#ntion



I9.I9. LANGUAGELANGUAGE

Spontan#ous sp##+-Spontan#ous sp##+- %&u#n+(, arti+u&ation,%&u#n+(, arti+u&ation,parap-asiaparap-asia

#ra& %&u#n+(4 Tota& 2ord4#ra& %&u#n+(4 Tota& 2ord4 Tota& ani$a&4Tota& ani$a&4

0o$pr#-#nsion0o$pr#-#nsion r#spons# to pointin' +o$$ands,r#spons# to pointin' +o$$ands,r#spons# to <(#s= or <no= /u#stionsr#spons# to <(#s= or <no= /u#stions

R#p#titionR#p#tition

Na$in' 8 >ord *indin'Na$in' 8 >ord *indin' +o&ors, od( parts,+o&ors, od( parts,

+&ot-in' 8 roo$ oj#+ts, parts o% oj#+ts+&ot-in' 8 roo$ oj#+ts, parts o% oj#+ts R#adin'R#adin'

>ritin'>ritin'

Sp#&&in'Sp#&&in'



9.9. MEMORYMEMORY

I$$#diat# r#+a&& s-ort t#r$ $#$or("I$$#diat# r#+a&& s-ort t#r$ $#$or("

Ori#ntationOri#ntation p#rson, p&a+#, ti$#p#rson, p&a+#, ti$#

R#$ot# $#$or(R#$ot# $#$or( p#rsona& in%or$ation, -istori+a&p#rsona& in%or$ation, -istori+a&

%a+ts%a+ts N#2 &#arnin' ai&it(N#2 &#arnin' ai&it( ? unr#&at#d 2ords, #ra&? unr#&at#d 2ords, #ra&

stor( %or i$$#diat# r#+a&&, isua& $#$or( -idd#nstor( %or i$$#diat# r#+a&&, isua& $#$or( -idd#n

oj#+ts",oj#+ts",

isua& $#$or( isua& d#si'n r#produ+tion",isua& $#$or( isua& d#si'n r#produ+tion", pair#d asso+iat#d &#arnin'pair#d asso+iat#d &#arnin'



9isua& M#$or(9isua& M#$or(

9isua& D#si'n9isua& D#si'n

R#produ+tion"R#produ+tion"



R#nd#rin' o%R#nd#rin' o%

d#si'n @d#si'n @




d#si'n d#si'n




d#si'n Bd#si'n B




d#si'n ?d#si'n ?



9I.9I. 0ONSTRU0TIONAL A)ILITY0ONSTRU0TIONAL A)ILITY

R#produ+tion dra2in'sR#produ+tion dra2in's






9#rti+a&9#rti+a&

Dia$ond T#stDia$ond T#st




t2o3t2o3di$#nsiona&di$#nsiona&

+ross t#st+ross t#st



R#nd#rin' o% B3R#nd#rin' o% B3di$#nsiona& +u#di$#nsiona& +u#

t#stt#st



R#nd#rin' o% B3R#nd#rin' o% B3

di$#nsiona& pip#di$#nsiona& pip#t#stt#st




trian'&# 2it-in atrian'&# 2it-in atrian'&# t#sttrian'&# t#st



Dra2in's to +o$$andDra2in's to +o$$and T#&& pati#nt to dra24T#&& pati#nt to dra24

0&o+k 2it- a&& nu$#rs0&o+k 2it- a&& nu$#rs

Dais( in %&o2#rpotDais( in %&o2#rpot



Hous# in p#rsp#+ti#Hous# in p#rsp#+ti#




dra2in's todra2in's to

+o$$and t#st+o$$and t#st

0LO0!0LO0!




dra2in's todra2in's to+o$$and t#st+o$$and t#st

*LO>ER1OT*LO>ER1OT




dra2in's todra2in's to+o$$and t#st+o$$and t#st

HOUSE INHOUSE IN1ERS1E0TI9E1ERS1E0TI9E



)&o+k d#si'n)&o+k d#si'n



0o$$on Error o%0o$$on Error o%

&o+k d#si'n t#st&o+k d#si'n t#st



9II.9II. HIGHER 0OGNITI9E *UN0TIONSHIGHER 0OGNITI9E *UN0TIONS

*und o% in%or$ation*und o% in%or$ation

0a&+u&ations0a&+u&ations #ra& rot# #6a$p&#s, #ra& +o$p&#6#ra& rot# #6a$p&#s, #ra& +o$p&#6

#6a$p&#s,#6a$p&#s, 2ritt#n +o$p&#6 #6a$p&#s2ritt#n +o$p&#6 #6a$p&#s in+&ud#d4in+&ud#d4

addition, sutra+tion, $u&tip&i+ation, diision"addition, sutra+tion, $u&tip&i+ation, diision"

1ro#r int#rpr#tation1ro#r int#rpr#tation

Si$i&ariti#sSi$i&ariti#s

0on+#ptua& s#ri#s +o$p&#tion0on+#ptua& s#ri#s +o$p&#tion



>ritt#n 0o$p&#6>ritt#n 0o$p&#6

E6a$p&#sE6a$p&#s

0a&+u&ation #rrors0a&+u&ation #rrors



9III.9III. RELATED 0ORTI0AL *UN0TIONSRELATED 0ORTI0AL *UN0TIONS

Id#o$otor apra6iaId#o$otor apra6ia Id#ationa& apra6iaId#ationa& apra6ia Ri'-t3&#%t disori#ntationRi'-t3&#%t disori#ntation id#nti%i+ation on s#&%,id#nti%i+ation on s#&%,

+ross#d +o$$ands on s#&%, id#nti%i+ation on+ross#d +o$$ands on s#&%, id#nti%i+ation on

#6a$in#r, +ross#d +o$$ands on #6a$in#r #6a$in#r, +ross#d +o$$ands on #6a$in#r *in'#r a'nosia*in'#r a'nosia G#rst$ann5s s(ndro$#G#rst$ann5s s(ndro$# 9isua& a'nosia9isua& a'nosia

Ast#r#o'nosis Ast#r#o'nosis G#o'rap-i+ disori#ntationG#o'rap-i+ disori#ntation

D#nia& 8 n#'&#+tD#nia& 8 n#'&#+t



*ronta& &o# t#sts*ronta& &o# t#sts

a. Dra2in'a. Dra2in'

. A&t#rnatin' -and s#/u#n+#s. A&t#rnatin' -and s#/u#n+#s



SUMMARY O* *INDINGSSUMMARY O* *INDINGS

@.@. D#s+ri# $ajor ar#as o% i$pair$#ntD#s+ri# $ajor ar#as o% i$pair$#nt

.. T#ntati# n#uro#-aiora& dia'nosisT#ntati# n#uro#-aiora& dia'nosis

B.B. T#ntati# &o+a&i:ationT#ntati# &o+a&i:ation

?.?. T#ntati# +&ini+a& dia'nosisT#ntati# +&ini+a& dia'nosis

C.C. 1ropos#d $ana'#$#nt p&ans1ropos#d $ana'#$#nt p&ans



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Kuliah Pasca MMSE Dan Strub & Black