Nervous System History

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An accurate description of the patient's neurological symptoms is an important aid in establishing the diagnosis; but this must be taken in conjunction with information from other systems, previous medical history, family and social history and current medication. Often the patient's history requires confirmation from a relative or friend.

The following outline indicates the relevant information to obtain for each symptom, although some may require further clarification.

Onset (sudden, gradual)

Timing (e.g. morning)

Precipitating factors (stooping, coughing)

Frequency

Duration

Frequency

Duration

Character (aching, throbbing)

Relieving factors (analgesics)

Site

Relieving factors (analgesics)

Site

Severity

Character (aching, throbbing)

Associated features (vomiting, visual disturbance)

Onset Frequency Duration

Onset Frequency Duration

HALLUCINATIONS

Precipitating factors

IMPAIRMENT

One/both eyes Total/partial visual loss Whole/partial field loss

DIPLOPIA - Gaze direction where maximal

HALLUCINATIONS

Precipitating factors

Field involved Formed, e.g. images (real) Unformed, e.g. shapes or zig-zags

Onset

Frequency

LOSS OF CONSCIOUSNESS

Precipitating factors

Frequency

LOSS OF CONSCIOUSNESS

Duration

Precipitating factors

Duration

ALCOHOL/DRUG ABUSE

CARDIOVASCULAR or

RESPIRATORY

symptoms

TONGUE BITING INCONTINENCE LIMB TWITCHING

ALCOHOL/DRUG ABUSE

HEAD INJURY

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