neuro HX

Question 1

first step

Answer 1

WIPER

ask for PT name, age and occupation

PC, golden minute, HPC

Question 2

general neuro screen - 11 things

Answer 2

1 - headache, facial pain
2 - neck stiffness or fever or rash vomit photophobia
3 - fits or faints
4 - dizziness or vertigo
5 - problems with vision, hearing or smell
6 - difficulty walking
7 - sudden onset weakness
8 - altered skin sensation
9 - bladder and bowel control
10 - involuntary movement or tremor
11 - speech, language or swallowing difficulty
12 - any nausea or vomiting
13 - is pt under stress of similar time course (tension h)

Question 3

relevant PMH risk factors to neuro

Answer 3

1 - cardiovasc disease and risk factors
2 - epilepsy
3 - meningitis and other infections
4 - trauma
5 - surgery
6 - any other medical conditions

Question 4

neuro FHx

Answer 4

1 - cardiovasc disease

2 - neuro or psych disease

Question 5

social hx relevant to neuro

Answer 5

1 - occupation
2 - smoking
3 - alcohol
4 - HIV risk factors
5 - syphillis risk factors
6 - toxin exposure

Question 6

relevant neuro DHx

Answer 6

1 - prescription
2 - over the counter
3 - alternative
4 - recreational
5 - allergies
6 - time course related to headache

Question 7

Hx specific to sudden onset weakness - 6 qs

Answer 7

1 - ask them to explain exactly what happened. 
2- time course 
3 - did they fall to the ground
4 - did they lose consciousness
5 - weakness on one side, both and face?
6 - associated with headache

• other general neuro screen e.g. visual disturbance etc

Question 8

hx specific to collapse - 15 qs

Answer 8

1- when
2 - situation at the time
3 - how they felt before
4 - did they lose consciousness and how long for
5 - any witnesses? what did they see
6 - incontinent or bite tongue?
7 - banged head or other injuries?
8 - how they felt immediately after
9 - how they feel now? any lasting damage?
10 - similar episode before? 
11 - dizzy or weak standing up from sitting or lying down. 
12  - cardiac hx
13 - if young and female any chance of pregnancy
14 - diabetic? 
15 - do they drive a motor vehicle
16 - other general neuro screen at end.