Luria motor test
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Luria three step motor test frontal lobe examination
Luria motor test, also called the Luria three-step motor sequencing test, is a bedside test of motor programming, sequencing, imitation, and frontal-executive function.
How to perform it
Ask the person to copy a repeating sequence with one hand placed on a table:
- Fist: closed hand resting on the table
- Edge: ulnar side of the hand on the table
- Palm: open palm flat on the table
Demonstrate: fist -> edge -> palm, several times.
Then ask the patient to repeat the sequence independently, usually first with one hand and then the other.
Then ask the patient to repeat the sequence independently, usually first with one hand and then the other.
Normal response
- Learns the pattern after demonstration
- Continues it accurately and smoothly without prompts
Abnormal response
- Cannot learn or maintain the sequence
- Omits or reverses a movement
- Needs repeated cueing
- Repeats the same movement despite correction, termed motor perseveration
- Has marked asymmetry between hands
What it assesses
It is used as a quick screen for dysfunction in frontal and frontostriatal networks, particularly the ability to organize sequential motor acts. Difficulty with sequential motor tasks such as the Luria 3-step test can occur in frontal lobe syndrome. See the StatPearls frontal-lobe review.
Important limitation
An abnormal test is not diagnostic by itself. Poor performance may also reflect weakness, tremor, bradykinesia, arthritis, apraxia, impaired comprehension, poor attention, or low cooperation. Interpret it alongside the full neurological and cognitive examination.
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Lithium is given in
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lithium bipolar disorder
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NICE bipolar disorder lithium treatment mania maintenance guideline
Lithium is given mainly in bipolar affective disorder, especially for:
- Acute mania
- Maintenance treatment to prevent manic and depressive relapse
- Reduction of suicide risk in bipolar disorder
- Augmentation in treatment-resistant major depression in selected patients
For a one-line exam answer: Bipolar disorder, particularly mania and prophylaxis of recurrent mood episodes.
Carbamizepine
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carbamazepine bipolar disorder
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NICE bipolar disorder carbamazepine recommendation
Carbamazepine is given for:
- Epilepsy, especially focal seizures and generalized tonic-clonic seizures
- Trigeminal neuralgia
- Bipolar disorder, particularly acute mania or as a mood stabilizer when lithium is unsuitable/ineffective
One-line exam answer: It is used in epilepsy, trigeminal neuralgia, and bipolar mania.
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