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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