Neurological history taking

Question 1

anatomical localisation

Answer 1

central lesion - brain or spinal cord
peripheral lesion - nerve root, nerve, neuromuscular junction, muscle

Question 2

common symptoms
of neurological problems

Answer 2

headache
loss of awareness/consciousness (fits/faints)
memory problems
change in behaviour
visual disturbance(blurred/double vision)
speech problems (expressive articulation, volume)
change in sense of smell
weakness or tremor
involuntary movements
hearing changes (loss, tinnitus)
imbalance or falls

Question 3

typical description of neurological episode

Answer 3

before - palpitations, light-headedness, visual changes, other sensory changes
during - length, loss of consciousness, arm/leg movement, eye movement, tongue biting
after - focal limb weakness, fatigue, confusion

Question 4

sudden onset of episode

Answer 4

seconds or minutes
could be vascular or due to trauma

Question 5

subacute onset of episode

Answer 5

hours or days
could be inflammatory, infective or immune-related

Question 6

chronic episodes

Answer 6

weeks, months or years
could be genetic or degenerative

Question 7

what medical conditions predispose neurological problems

Answer 7

atrial fibrillation
diabetes
hypertension
rheumatoid arthritis
GI problems
cancer
HIV
blood disorders

Question 8

what other things may predispose a neurological condition

Answer 8

history of chronic neurological diseases
developmental history - prematurity, developmental milestones
previous head injury or neurological infections
drug/medication use
family history of neurological conditions