Neuro History Taking Flashcards
What are the 5 groups of risk factors to ask about?
- Head trauma
- Raised ICP
- Meningism
- Giant Cell Arteritis
- Stroke
What questions do you ask when concerned about raised ICP?
Early morning vomiting
Headache worse in morning
Headache worse on coughing
Headache worse lying and better standing
Headache worse when moving head up and down
Tinnitus: sounds in ears
What questions do you ask when you’re concerned about meningism?
Neck stiffness
Rash
Photophobia
Fever
What questions do you ask when concerned about GCA?
Pain over templed
Pain when brushing hair
Jaw claudication
Blurred vision
What risk factors questions do you ask when concerned about stroke?
High BP
Heart Disease
DM
High cholesterol
Atrial fibrillation
Smoking
HRT/OCP
Past TIA
What general questions should you screen for in a neuro history?
Weakness
Sensory disturbances
Speech disturbances
Visual disturbances
Seizures
Change in smell/taste/hearing
Ataxia/balance problems
Dysphagia
Loss of consciousness
What constitutional symptoms should you ask in a neuro history?
Fever
Weight loss
Malaise
Anorexiaq
What should you ask about visual disturbances?
Type: vertigo, hemianopia, amaurosis fugax
Severity: blurred or lost
Onset and duration
What should you ask about weakness?
Distribution
Severity: weak or flaccid paralysis
Onset and duration
Course
Resolution
What should you ask about changes to sensation?
Distribution
Severity: tingling, numbness, pins and needles
Onset and duration
Resolution
What should you ask about balance problems/ataxia?
Course and timing
Impact on ability to walk
Associated symptoms suggestive of posterior circulation stroke: vertigo, nausea
What should you ask about dysphasia?
Expressive dysphasia: I knew what I wanted to say but couldn’t
Repetitive dysphasia: I wasn’t able to understand anyone, they were talking gibberish
Dysarthria: slurred speech
