specific questions to ask in a neuro history

Question 1

questions to review neuro system

Answer 1

headaches
visual disturbances
hearing/speech difficulties
dizziness, vertigo
faints, fits, blackouts
weakness, numbness
sleep disturbnaces
unsteadiness
tremors
concentration
memory

Question 2

specific headache questions in a neuro history

Answer 2

where is pain - uni/bilateral, from, back etc
how did it come on - sudden/gradual
what does it feel like - throbbing, tight band
does the pain radiate anywhere
do you have any other symptoms - N&V, altered conscious lvl, rash, fever, neck stiffness, light sensitivity, vision changes, aura, tender scalp, malaise
how often do you have it - constant, intermittent, single/recurrent
how long do they last
worse at certain times/days/months
anything make it worse/trigger it - noise, stress, bending, standing straight, coughing, sneezing, eating, combing hair, birght/flashing lights
anything make it better - dark room, lying down, rest, analgesia
severity scale

Question 3

question to ask about LOC/TIa

Answer 3

could you describe whole thing in your own words
what happened before, during and after
how did it come on - sudden/gradual
time of day
what were you doing at the time
any pain/stress/prolonged standing
how did you feel before episdoe
any dizziness, nausea, vertigo, aura, palpitations, sweating, weakness, slurred speech, headache, tongue biting, incontinence, stiff limbs, jerking limbs, eyes open, responsive/aware
how long did it take to recover
how did you feel after episode
have you had it before
was it witnessed and if so what did they say

Question 4

red flag questions to ask for headaches

Answer 4

sudden headache with max severity w/in 5 mins
headache with fever, neck stiffness and altered mental state
new onset of focal neuro deficit
decreased level of consciousness
recent head trauma w/in last 3 months
headache that is posture dependent
headache with temporal tenderness
headache with severe eye pain, reduced vision, N&V

Question 5

specific PMHx for neuro history

Answer 5

head/spinal trauma
diabetes/metabolic/endocrine disorders
cancers
HTN
epilepsy
AF
heart disease

Question 6

specific drug Hx for neure Hx

Answer 6

anticonvulsants
anticoagulants/antiplatelets
analgesics
antiHTN
antidepressants
insulin
recreational drugs

Question 7

specific FHx for neuro Hx

Answer 7

diabetes
cerebral haemorrhage
stroke/cerebrovascular disease
IHD
migraine
epilepsy

Question 8

specific stroke/TIA history questions

Answer 8

weakness
sensory disturbance - loss of sensation/pins and needles
visual disturbance
speech difficulties
can you understand things like normal
any difficulties in balancing/walking
any difficulties swallowing

any recent surgeries - heart surgery