Sign up to start your free trial of MedSchool Premium!Get Started

Neurological History-Taking

Bookmark

Presenting Complaints

Headache

Onset, severity, location, aggravating / relieving, prodromal symptoms
Seizure

Witnessed, duration, LOC, collateral
Presyncope / Syncope

Lightheadedness / loss of consciousness
Visual Changes

Blurring, diplopia, amaurosis fugax
Visual Blurring

Onset, use of glasses
Diplopia

Onset, associated symptoms
Amaurosis Fugax

Temporary visual loss without pain
Olfactory Changes

Loss of olfactory sensation, altered olfaction
Hearing Changes

Tinnitus, hearing loss
Tinnitus

Constant or intermittent, triggers
Hearing Loss

Degree of hearing loss, impact on function
Vertigo

Room spinning or patient spinning
Muscular Symptoms

Weakness, spasm, tremor, facial droop
Muscle Weakness

Proximal or distal
Muscle Spasm

Which muscles, situation
Tremor

Resting or with activity
Facial Droop

Onset, associated symptoms
Sensory Changes

Loss of sensation / tingling / burning
Numbness

Location, constant or intermittent
Paraesthesia

Pins & needles

Location, constant or intermittent
Neck Stiffness

Fevers, headache, photophobia
Dysarthria

Difficulty articulating

Onset, associated symptoms

Further History

Handedness

± Footedness
Description of a Single Episode

Before, during, after
Pattern of Events Over Time

First event, max frequency, Sx-free interval
Circumstances of Attacks

Precipitants, aggravators, alleviators
Trauma

Cerebral, neck or back

Past Medical History

Cerebrovascular Events

TIA / stroke

How many, when, functional residual
Epilepsy

Frequency / last seizure, type of seizures
Migraines

Frequency, severity, symptoms, impact
Multiple Sclerosis

Family history, relapses, management
Parkinson's Disease

Symptoms, dopamine replacement regimen
Motor Neuron Disease

Clinical phenotype, manifestations, management, prognosis
Myaesthenia Gravis

Symptoms, past myaesthenic crisis
Cerebrovascular Risk Factors

IHD, AF, HTN, lipids, Diabetes
Ischaemic Heart Disease

When diagnosed, symptoms, past coronary events, echo / angio results, management
Atrial Fibrillation

Paroxysmal / constant, CHADS2, anticoagulation, past TIA / stroke
Diabetes

Diagnosis, control, management, complications
Hyperlipidaemia

When diagnosed, lipid results, meds, diet
Hypertension

Latest BP readings, meds, complications

Medications

Family History

Known Family Neurological History

Family tree, age of onset

Social History

Education

Level of education attained
Vocation

Toxin exposure
Recent Travel

Where, when, how long
Degree of Support Available

Physically and psychologically
Impact of Presenting Complaint

On relationships, work etc.

Substance History

Alcohol

Average per day / week
Smoking

Pack-years, years since quitting
Recreational drugs
Acute intoxication

Illicit drug use, alcohol, opiates, methamphetamine etc
Withdrawal

Recently ceased drugs

On this page: Presenting Complaints Further History Past Medical History Medications Family History Social History Substance History

Read More...

Ascherio A, Munger KL. Environmental risk factors for multiple sclerosis. Part II: Noninfectious factors. Annals of Neurology: Official Journal of the American Neurological Association and the Child Neurology Society. 2007 Jun;61(6):504-13. Belbasis L, Bellou V, Evangelou E, Ioannidis JP, Tzoulaki I. Environmental risk factors and multiple sclerosis: an umbrella review of systematic reviews and meta-analyses. The Lancet Neurology. 2015 Mar 1;14(3):263-73. Dharmadasa T, Henderson RD, Talman PS, Macdonell RA, Mathers S, Schultz DW, Needham M, Zoing M, Vucic S, Kiernan MC. Motor neurone disease: progress and challenges. Medical Journal of Australia. 2017 May;206(8):357-62. Ferlisi M, Shorvon S. Seizure precipitants (triggering factors) in patients with epilepsy. Epilepsy & Behavior. 2014 Apr 1;33:101-5. Hajat C, Dundas R, Stewart JA, Lawrence E, Rudd AG, Howard R, Wolfe CD. Cerebrovascular Risk Factors and Stroke Subtypes: Differences Between Ethnic Groups. Stroke. 2001; 32: 37-42. Hayes MW, Fung VS, Kimber TE, O'Sullivan JD. Current concepts in the management of Parkinson disease. Medical Journal of Australia. 2010 Feb;192(3):144-9.

Jankovic J. Parkinsons disease: clinical features and diagnosis. Journal of neurology, neurosurgery & psychiatry. 2008 Apr 1;79(4):368-76.

Juel VC. Myasthenia gravis: management of myasthenic crisis and perioperative care. InSeminars in neurology 2004 Mar (Vol. 24, No. 01, pp. 75-81). Copyright© 2004 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.. Keesey JC. Clinical evaluation and management of myasthenia gravis. Muscle & Nerve: Official Journal of the American Association of Electrodiagnostic Medicine. 2004 Apr;29(4):484-505. Kennedy A, Zakaria R. Taking a Neurological History. Medicine. 2006; 36(10): 509-514. Lima, Marco A. What is the essential neurological examination?. Arquivos de neuro-psiquiatria. 2012 Dec; 70(12): 939. McDermott CJ, Shaw PJ. Diagnosis and management of motor neurone disease. Bmj. 2008 Mar 20;336(7645):658-62. Murthy JM, Meena AK, Chowdary GV, Naryanan JT. Myasthenic crisis: clinical features, complications and mortality. Neurology India. 2005 Jan 1;53(1):37.

O'Brien MD. Taking a Neurological History. The Foundation Years. 2006; 2(1): 1-6.

Palace J. Making the diagnosis of multiple sclerosis. Journal of Neurology, Neurosurgery & Psychiatry. 2001 Dec 1;71(suppl 2):ii3-8.

Pearl PL. Neurological Problems of Jazz Legends. Journal of Child Neurology. 2009 Aug; 24(8): 1037-1042.

Perlmutter JS. Assessment of Parkinson disease manifestations. Current protocols in neuroscience. 2009 Oct;49(1):10-.

Sanders DB, Wolfe GI, Benatar M, Evoli A, Gilhus NE, Illa I, Kuntz N, Massey JM, Melms A, Murai H, Nicolle M. International consensus guidance for management of myasthenia gravis: executive summary. Neurology. 2016 Jul 26;87(4):419-25. Shorvon SD. The etiologic classification of epilepsy. Epilepsia. 2011 Jun;52(6):1052-7. Simpson S, Blizzard L, Otahal P, Van der Mei I, Taylor B. Latitude is significantly associated with the prevalence of multiple sclerosis: a meta-analysis. Journal of Neurology, Neurosurgery & Psychiatry. 2011 Oct 1;82(10):1132-41.

Talbot K. Motor neurone disease. Postgraduate medical journal. 2002 Sep 1;78(923):513-9.

Feedback