Neurological History

Simon Mung

Overview

PC HPC PMH Dhx dizziness and headache Fhx Shx

FASTWICE

Family, alcohol, smoke, travel, work, ideas, concerns, expectations

History Neurology

What do you mean by: dizziness, fit, migraine, vertigo Headache: SOCRATES Surely varying headaches should not be new wacko (SVHSNBNW)

Seizure, vomiting, headache, sight (and other senses, photophobia), nausea, behaviour, numbness, weakness

Headache

For how long?

S: Generalised or focal? O: Acute or chronic? Intermittent or constant? If chronic getting worse? C: Throbbing? Band around the head? R A: SVHSNBNW especially migraines (aura) T: Lasts for how long? E: Cough/worse in the morning? Relieving factors S: Lose consciousness? Ever had to take time off work? Severity scale

Differentials

Acute conditions
Meningitis Headache Neck stiffness Photophobia Fever Rash SAH Headache Neck stiffness Photophobia LOC

Faint

Low in...

Glucose - DM Cardiac output Heart (syncope) Brain... - Epilepsy

Seizure

Before: Stimuli? Witness? Aura? (Visual changes photophobia, scotoma) During: LOC? If so, for how long? Pallor? Eyes rolled back? Tongue-biting? Urinary incontinence? After: Confusion? How long it took to be back to normal

v0y50@students.keele.ac.uk