Dr Warren: Neurological History Taking
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Transcript of Dr Warren: Neurological History Taking
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Neurological history taking(+ how to write a helpful letter)
Dr Naomi Warren
Consultant neurologist
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History Key to diagnosis Essential skill Key areas in brief appt:
Main symptoms Previous neurological events Relevant PMH and Ix Relevant medication
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Main Symptoms Onset – how + when Progression Details of symptoms
Eg site/character headache Funny dos – before/during/after
Relevant associated features Important negatives
Eg visual symptoms with headache Stiffness/slowness with tremor
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Previous neurological events Headache
Any headaches when younger ?Multiple sclerosis
Any previous episodes visual loss/vertigo Blackouts
Any febrile seizures/HI? Previously seen by neuro + why?
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Investigations/Meds Investigations
Scans/eeg/ncs – esp if many years ago Medication
With doses of relevant drugs Previous meds eg failed drugs in headache, antipsychotics
if parkinsonism
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Letters to Neurology
History as described Relevant examination What question are you asking us? Patients expectations/worries
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Good: Clear description events, Relevant Ix,Not included: relevant PMH + meds, question?
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Good: description,previous meds + mgmt, relevant PMH and examination, relevant Ix, question.
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Summary Detailed history is key to diagnosis Time course and pattern Communicate relevant background What is the question?