In this section : Neurology
Cognitive Function
Conscious Level
Stroke Care
Idiopathic Intrancranial Hypertension
Myasthenia Gravis
Serotonin Syndrome
Neuroleptic Malignant Syndrome
Guillain-Barré Syndrome
Acute Vertigo
Transient Global Amnesia
Brain Tumours
Lumbar Puncture
Transient Loss of Consciousness
Other Funny Turns
Haematemesis – ACP
Head and Neck Injury
Severe Headache
Status Epilepsy in Adults
The First Seizure
Multiple Sclerosis
Coma
Cognitive Function
Last updated 26th March 2024
Abbreviated Mental Test
- Cognitive impairment is common in elderly people and is associated with increased morbidity and mortality. Routine cognitive screening of elderly patients is recommended by AMT (as shown below).
- Each correct response scores 1 mark. No half marks given. Scores 8-10 normal; 7 probably abnormal; ≤6 abnormal. Persistent score of 6 or less suggests patient may have problems with self care or new concepts and will require multidisciplinary assessment
Test Item Scoring Instructions Age Exact age only Date of Birth Accept day/month Year Current year only Time of Day Correct to nearest hour Place Name of hospital Monarch Current Monarch only Year of First World War Year of start or finish Count backwards from 20 to 1 No mistakes from 20 - 10 Recognition of two people eg Doctor, Nurse, etc Recall of three point address Repeat by patient eg 42 West Street, ensure it has been heard correctly and then recall at end of test
AMT4
- An abbreviated form of the AMT containing only 4 items is said to be almost as good as the AMT itself.
- The first to go when a patient has dementia or becomes confused is usually the year
- The items are: Age, Date of Birth, Year, Place
4AT for Delirium Screening
- Literally the 4A Test
- Should be used if patient drops one or more mistakes in the AMT4.
- The critical A is Acute Change, which can only be determined by speaking to a relative or carer.
Criterion Normal Alertness
May ask patient to state name and address to help with ratingAlert and neither drowsy or hyperactive AMT4
Age, date of birth, place (name of the hospital or buildingNo mistakes Attention
Instruct patient to list months in reverse order starting at DecemberLists ≥7 months correctly Acute change of fluctuating cours. Can only determine this by speaking to a relative or carer No evidence of significant change or fluctuation in mental status within the last 12 weeks