Neurological History Taking Flashcards
(31 cards)
What should you be observing when looking at a patient?
- State of health
- Mode of dress
- Age
- Eye contact
- Mood
- Tics
What should you be looking out for in regards to the content of conversation with a patient?
- Level of education
- Intelligence
- Mood
What is dysphasia?
Language disorder as a result of brain damage which causes a deficiency in the generation of speech
What is dysarthria?
motor speech disorder resulting from neurological injury of the motor component of the motor–speech system and is characterized by poor articulation of phonemes.
What can dizzy mean?
- Rotatory movement or light hadedness
- Common cause is benign positional vertigo
What is benign positional vertigo?
Dizziness which comes on suddenly (feels like on a roundabout - usually fine when head kept still)
What should your follow up questions be after PC?
- Duration of symptoms
- Speed of onset
- Location
- Variation
- Intensity
What are common neurological presentations?
- Altered cognitive ability
- Fits, faints and funny turns
- Headache
- Dizziness
- Weakness or movement disorders
- Numbness or sensory disorders
- Visual impairents
What are some good questions to ask in order to find out about pattern recognition?
- Have you noticed any changes in your writing
- Any differences in the way you walk
If someone collapses what are the 3 most likely origins of the collapse?
- Neurological
- Cardiovascular
- Endocrine
How common is epilepsy?
~ 1% of population
WHat can cause/trigger seizures?
- Abnormal electolytes
- Abnormal blood glucose
- Under stress - no sleep for a prolonged period of time
- Can affect everybody (just depends on seizure threshold)
How can fits, faints and funny turns be diagnosed?
- Good history from patient
- Description from witness
- If recurrent think of asking to record the event
What should you ask in relation to a seizure?
- What was happening immediately before?
- What factors might have lowered the seizure threshold?
- What position was the patient in?
- Any prodromal symptoms?
- After?
What should you ask in regards to the time course and evolution of neurological symptoms?
- Sudden e.g. “thunder clap” headache
- Recurrent (but well between episodes)
- Deterioration over hours (infection)
- Relapsing / remitting (MS?)
- Deterioration over weeks / months (Degenerative disease)
What should you ask or be thinking about when weakness is mentioned?
- Chronic “aesthenia” “fatigue” or specific muscle weakness
- What activities are they finding difficult (proximal or distal muscles)
- Is the problem in the muscle or in the nerve supply to the muscle
What can the ice pack test diagnose?
Myasthenia Gravis (reduced ptosis in the eye)
What should be asked in relation to walking?
- Has the distance they can manage changed?
- Why? What makes them stop?
- What about hills?
- One leg or both?
- Any sensory symptoms?
What can be the cause of too little movement?
Parkinson’s
What can be the cause of too much movement?
- Chorea - “fidgety jerks”
- Can be over treatment of Parkinson’s
What is Allodynia?
a condition where pain is caused by a stimulus that does not normally elicit pain
What can paraesthesia be described like?
Tight bandage wrapped around the leg
What should you refer to when treating/diagnosing younger patients?
- Was there any evidence of developmental delay (1 to talk 2 to walk)
- Also think birth history/complications
- Regression is always a red flag
What should you be thinking/ask in relation to drugs?
- What treatment are they on
- Are they complaint
- Is it optimal
- Could it be the cause of the problem
- Is there any interaction between the drugs
- Is the patient thinking of becoming pregnant
- Allergy
