Neurological History

Question 1

Bell’s Palsy

Answer 1

INCLUDING forehead - LMN

Question 2

Causes of secondary headache

Answer 2

Meningitis (photophobia? rash?)
Stroke (thunderclap?)
Brain tumour (ask about weight loss)
Dehydration

Question 3

Epilepsy

Answer 3

Type? Jerking
Sensations? Aura and post ictal

Question 4

PC: headache
SOCRATES

Answer 4

S - ask the patient to point, unilateral/bilateral?
O - sudden/gradual? thunderclap?
C - throbbing? tight band? worst ever?
R - does it radiate?
A - nausea/vomiting, altered conscious level, rash, fever, neck stiffness, light sensitivity, visual loss, blurred vision, aura, tender scalp, malaise
T - constant/intermittent, single/recurrent, duration of episodes, worse at certain times of day/month/year?
E - CHOCOLATE, noise, stress, bending, standing up, coughing, eating, combing hair, bright or flashing lights, certain foods/drugs, dehydration
Relieving - analgesia, dark environment, lying down, rest
S - 1-10

Question 5

PC: transient loss of consciousness

Answer 5

Onset - gradual/sudden?
Time of day
What were you doing at the time?
Any pain, injections, hot crowded rooms, emotional stress, prolonged standing
How did you feel before the episode?
How long did it take to recover? Any amnesia, aggression, emotional?
Previous episodes, like the current one or different?
Was the episode witnessed?

Question 6

PC: transient loss of consciousness
Associated symptoms?

Answer 6

Dizziness
Nausea
Vertigo
Aura
Palpitations
Sweating
Weakness
Sensory symptoms
Slurred speech
Headache
Tongue biting
Incontinence
Stiffening/jerking of limbs
Awareness? Responsiveness during episode?
Eyes open or closed?
Groans?