5. Neurological History Taking

Question 1

Name 4 assessment tools for cognitive assessment?

Answer 1

4AT
Mini mental state examination (MMSE)
Montreal cognitive assessment (MoCA)
Addenbrookes Cognitive examination (ACE III)

Question 2

Describe the 4ATs test?

Answer 2

Rapid
Initial assessment for delirium and severe cognitive impairment
Looks at:
-Alertness
-AMT 4
-Attention
-Acute change or fluctuating course

Question 3

What is delirium?

Answer 3

Mental confusion that can happen if someone becomes medically unwell
“Acute confusional state”
Common 1:10 hospital patients

Question 4

What is MoCA?

Benefits?

Answer 4

Montreal cognitive assessment (2005)

Benefits:

• No copyright
• Better at identifying mild levels of impairment
• Less bias ethnicity/age/education

Question 5

Features of ACE III test?

Answer 5

• About 20 minutes to do
• Scored out of 100
• 5 cognitive domains:
– Attention
– Memory
– Verbal fluency
– Language
– Visuospatial abilities

Question 6

What is confabulation?

Which illnesses?

Answer 6

Presenting false information with great authority and certainty.
Often autobiographical in nature
No intent to deceive

Illnesses associated:

• Korsakoff’s syndrome
• Alzheimer;s dementia

Question 7

3 experiences/descriptions of benign positional vertigo?

Answer 7

The dizziness started suddenly when I was in bed and rolled over…
Feels like I am on a roundabout…lasts a couple minutes then settles
OK if I keep my head still but if I look up suddenly it can start again

Question 8

name 6 common neurological presentation?

Answer 8

• Altered cognitive ability
• Fits, faints & funny turns
• Headache
• Weakness or movement disorders
• Numbness or sensory disorders
• Visual impairments

Question 9

Which condition may result in too little movement?

Answer 9

Parkinsons leads to slowing of movement and stiffness

Question 10

Which conditions could lead to too much movement?

Answer 10

Chorea = Fidgety jerks
Choreoathetosis = Decreased tone, rapid and writhing changes in movement

Question 11

What is paraesthesia feel like?

Answer 11

Sensory disorder than feels like a tight bandage wrapped around the limb

Question 12

What does allodynia mean.

Answer 12

Central pain sensitization (increased response of neurons) following normally non-painful, often repetitive, stimulation. Allodynia can lead to the triggering of a pain response from stimuli which do not normally provoke pain.

Question 13

What is an ADL?

Answer 13

Activity of daily living

e.g. eating, bathing

Question 14

What are the cranial nerve brief screening q’s?

Answer 14

Vision? Double vision?
Dry eyes? Dry mouth? Change in taste? Hearing? Dizziness?
Change in voice?
Articulation?
Change in your sense of smell?