Neurology History

Question 1

Falls

Answer 1

History

• PC
  
  • Frequency
    
    • Pattern / common precipitating factor?
  • Before
    
    • What were they doing?
    • Any warning?
  • During
    
    • Loss of consciousness
      
      • Duration
      • Tongue biting, incontinence, seizure?
  • After
    
    • Post-ictal
    • How long did it take to become re-orientated?
    • Any weakness, dysarthria, facial drooping?
  • Exclude mechanical
    
    • Mobility
    • Vision
  • Exclude cardiac
    
    • Palpitations, chest pain, SOB?
    • Risk factors
• PMH
  
  • Epilepsy
  • Heart problems
  • Stroke
  • Diabetes
  • Arthritis
• DH
  
  • Antihypertensives
• FH
• SH
  
  • Support
  • Smoking
  • Alcohol

Question 2

Headache

Answer 2

• SOCRATES
  • Site
  • Onset
    
    • Sudden
      • Vascular
    • Gradual
• Character
  
  • Throbbing
  • Tightness
• Radiation
• Associated symptoms
  
  • Vomiting
  • Red flags
    • Jaw claudication
    • Visual disturbance
    • Neck stiffness
• Time
  
  • Duration
    
    • Constant / Intermittent
  • Time of day
  • Wake from sleep?
  • Frequency
  • Why seek help now?
• Exacerbating / Precipitating & Alleviating factors
  
  • Coughing
  • Leaning forwards / posture
  • Diet
  • Menstrual cycle
    • Analgesics
      
      • What, amount, how often (medication overuse?)
    • Going to bed
• Severity
  
  • How much are activities limited?
• Other
  
  • Between attacks
    • Completely well, or any residual or persisting symptoms?
• ICE - Concerns about recurrent attacks or their cause?
• HPC
  • Prodrome
  • Have you experienced headaches like this in the past?
  • Have headaches changed?
• PMH
• DH
• FH
• Smoking & alcohol
• SH
  • Occupation
  • Driving
  • Support at home