The main purpose of assessment of the palate during the neurologic examination is to look for evidence of dysfunction of the vagus (tenth) nerve. In some cases, palatal movement is assessed to look for evidence of neuromuscular disease causing palatal weakness.

Palatal movement should be assessed in most patients as part of a routine neurologic examination. Palatal movement should be particularly assessed in patients who have complaints of difficulty swallowing or slurred speech, or in patients who are suspected of having a severe neuromuscular disorder that may cause palatal weakness. A gag reflex rarely, if ever, needs to be performed on any awake patient as part of a standard neurologic examination, however.

Palatal movement occurs because of innervation by the vagus (tenth) nerve of the pharyngeal muscles that elevate the palate. The origin of the vagus nerve is in the medulla. The left vagus nerve innervates the left palatal muscles, and the right vagus nerve innervates the right palatal muscles.

A tongue depressor and a flashlight.