This month we’re changing gears a bit and putting away our hi-tech airway equipment to evaluate a unique pocket tool for improving neurological assessments: the Neuro 7. Designed by an emergency physician, the Neuro 7 is an all-in-one device for the closet neurologist in all of us. Roughly the size of a small TV remote, the lightweight, stainless steel device fits easily in your palm. Its self-contained style steals a bit from the school of Swiss Army knives with sliders and hinges that reveal seven retractable neuro-testing tools, which we’ll examine one by one.
First is the reflex hammer. While not shaped like a conventional hammer, the Neuro 7 has the same Taylor and buck small point styles offered in a standard pocket reflex hammer. The weight of the head is also slightly less than a standard hammer. Unlike a typical hammer with a concavity on both sides, the curvature of the Neuro 7—convex on one side and concave on the other—makes the hammer a little unwieldy but not overly difficult to use.
Just below the hammer head is a bright white LED light. If you’ve not used an LED light yet they are significantly brighter than filament bulbs, and the strong light on the Neuro 7 is no exception. It’s powered by a fully-charged, replaceable battery that should last for up to 8,000 uses of the LED feature.
To assess pain sensation, a sharp/dull, metal testing instrument located at one end of the device can be activated with a thumb-slide, which allows it to fully retract into the device when the instrument is not in use. The tips feel sturdy, and have a slight catching lock when fully extended. They work well, and the Neuro 7 also comes with disposable plastic sharp tips for point testing.
Next to the sharp/dull instrument is a light touch brush. It operates in the same retractable fashion as the sharp/dull tool and is really nothing more than a small paint brush on a slider but again serves its purpose well.
Flipping the device over reveals another slider but with a two-point discriminator. This tool is perhaps the most useful and interesting part of the Neuro 7. The graduated two-point discriminator increases in width as you slide it further out starting as a single point and adjusts to 20 mm in 2 mm increments per the scale on the side of the slider. Like the devices’s companion sliding tools, the two-point discriminator is made of metal and very sturdy.
Alongside the two-point discriminator is a hinge that serves a dual purpose as a dull edge for Babinski reflexes and painful stimuli. The hinge also has a small slot where a small disposable monofilament fits in place for tactile sensation. This hinge allows the device to be opened up revealing an embedded Wartenberg pinwheel for tactile sensation testing. It is made of plastic and is replaceable.
The Neuro 7 also has a few extras including a row of circles located along its side for pupillary size measurement, and a metric ruler that is 110 mm in length. Both thoughtful additions could see frequent use in the ED.
Prices for the Neuro 7 are: $92.50 for the device; $29.95 for a disposable pack of 50 sharp tips, 20 pinwheels, and 50 monofilaments; $18.50 for a nylon case; and $3.85 for a replacement battery. Separate disposable replacements are also available for various prices.
The Neuro 7 is a great combo device featuring nearly all of the tools you need for a thorough neuro exam. It is small, versatile and portable. It even comes with a clip allowing you to carry on your hip. That said, even for a gadget geek like myself, this hip holster is a bit much. I’ll carry this one in my bag, thank you very much. At nearly $100, the price is a drawback; you’ll have to decide if it’s worth the money in your ED. But for the techy looking for the next gadget fix, its a useful device that you will be very happy with despite its limited ED use and relatively high price.
Pros: It’s versatile, compact and extremely functional; it’s got it all.
Cons: Slightly pricey for the value and a bit gimmicky.
Will you really use it?