NEUROLOGIC HISTORY TAKING

Le Thi Ngoc Suong

Order of neurologic history taking.Some neurologic symptoms and relevant medical terms.Objectives

History taking = investigating through asking

History taking stepsAgeChief complaintHistory of present illnessPast medical historyFamily historySocial historyReview of system

Epilepsy, multiple sclerosis, Huntington diseaseAlzheimer disease, Parkinson disease, stroke1. Age

Some common neurologic complaints:ConfusionDizzinessWeaknessShakingNumbnessBlurred visionSpells2 Chief complaint

2 Chief complaint

ConfusionDizzinessWeaknessShakingNumbnessBlurred visionSpellsMemory impairmentVertigoLoss of powerChoreaHypesthesiaDiplopiaEpisodic epilepsy or syncope Faulty judgementPersonality changeVertigoPresyncopeLethargyTremorAthetosisMyoclonusHyperesthesiaParesthesia

2 Chief complaint

ConfusionMemory impairmentGetting lostDifficulty understanding or producing spoken or written languageFaulty judgmentPersonality change

2 Chief complaint

DizzinessVertigoImbalancePresyncope

2 Chief complaint

WeaknessLoss of powerGeneralized fatigueLethargySensory disturbance

2 Chief complaint

ShakingTremorChoreaAthetosisMyoclonusFasciculation

2 Chief complaint

NumbnessHypesthesia = hypoestheisHyperesthesiaParesthesia

2 Chief complaint

Blurred visionDiplopiaOcular oscillationReduced visual acuityVisual field cutsSpellsEpilepsysyncopy

Quality of symptomsLocation of symptomsTime coursePrecipitating, Exacerbating, Alleviating FactorsAssociated symptoms

3. History of present illness

Time course 3. History of present illness

IllnessesOperationsObstetric HxMedicationsImmunizationsDietTobacco, Alcohol, other Drug use4. Past medical history

Illnesses:Preexisting illnesses: hypertension, diabetes, heart disease, cancer, human immunodeficiency virus (HIV) disease.4. Past medical history

Operations:Entrapment neuropathies4. Past medical history

Obstetric history:EpilepsyEclampsia4. Past medical history

Medications:Some adverse neurologic effects:Confusional states, coma, headache, ataxia, seizures,

4. Past medical history

Immunizations:Vaccination: poliomyelitis, diphtheria, rabies, meningococcal of Haemophilus influenza meningitis, Japanese encephalitis.

Rare complications: post vaccination autoimmune encephalitis, myelitis, neuritis

4. Past medical history

Diet:Vitamin B1: Wernicke- Korsakoff syndrome, polyneuropathy in alcoholicsVi. B3: pellagra (dementia)Vi.B12: pernicious anaemia (megaloblastic madness).Vi.E: spinal cord degenerationExcessive consumption of fats: strokePreserved foods: botulinum toxin

4. Past medical history

Tobacco, Alcohol, other Drug use:Tobacco: lung cancer, may metastasize to CNS, paraneoplastic neurologic syndromes.Alcoholic abuse: withdrawal seizures.Intravenous use: HIV disease, infection, or vasculitis.

4. Past medical history

5. Family historyX-linked recessiveAutosomal dominantAutosomal recessive123

Education, occupationSexual history: sexually transmitted diseases (syphilis, HIV).Travel history.

6. Social history

GeneralImmuneHematologicEndocrineSkinEyes, ears, nose, and throatCardiovascularRespiratoryGastrointestinalGenitourinaryMusculoskeletalPsychiatric

6. Review of systems

Take-home message

Thank you for your attention