NEUROLOGIC HISTORY

TAKING
Le Thi Ngoc Suong

Objectives
1. Order of neurologic history taking.
2. Some neurologic symptoms and
relevant medical terms.

 History taking = investigating

through asking

History taking steps

Age
Chief complaint
History of present illness
Past medical history
Family history
Social history
Review of system

1. Age
Epilepsy, multiple sclerosis,
Huntington disease
Alzheimer disease, Parkinson
disease, stroke

2 Chief complaint
Some common neurologic complaints:
Confusion
Dizziness
Weakness
Shaking
Numbness
Blurred vision
Spells

2 Chief complaint
Confusion
Dizziness
Weakness
Shaking
Numbness
Blurred vision
Spells

Memory impairment
Vertigo
Loss of power
Chorea
Hypesthesia
Diplopia
Episodic epilepsy or syncope
Faulty judgement
Personality change
Vertigo
Presyncope
Lethargy
Tremor
Athetosis
Myoclonus
Hyperesthesia
Paresthesia

2 Chief complaint
Confusion

Memory
impairment
Getting lost
Difficulty
understanding or
producing spoken
or written
language
Faulty judgment
Personality change

2 Chief complaint
Dizziness

Vertigo
Imbalance
Presyncope

2 Chief complaint
Weakness

Loss of power
Generalized
fatigue
Lethargy
Sensory
disturbance

2 Chief complaint
Shaking

Tremor
Chorea
Athetosis
Myoclonus
Fasciculation

2 Chief complaint
Numbness

Hypesthesia =
hypoestheis
Hyperesthesia
Paresthesia

2 Chief complaint
Blurred vision

Diplopia
Ocular oscillation
Reduced visual
acuity
Visual field cuts

Spells

Epilepsy
syncopy

3. History of present illness

Quality of symptoms
Location of symptoms
Time course
Precipitating, Exacerbating,
Alleviating Factors
Associated symptoms

3. History of present illness

Time course

4. Past medical history

Illnesses
Operations
Obstetric Hx
Medications
Immunizations
Diet

Tobacco, Alcohol, other

Drug use

4. Past medical history

Illnesses:
Preexisting illnesses:
hypertension, diabetes, heart disease,
cancer, human immunodeficiency
virus (HIV) disease.

4. Past medical history

Operations:
Entrapment neuropathies

4. Past medical history

Obstetric history:
Epilepsy
Eclampsia

4. Past medical history

Medications:
Some adverse neurologic effects:
Confusional states, coma, headache,
ataxia, seizures,

4. Past medical history

Immunizations:
Vaccination: poliomyelitis, diphtheria,
rabies, meningococcal of Haemophilus
influenza meningitis, Japanese
encephalitis.
Rare complications: post vaccination
autoimmune encephalitis, myelitis,
neuritis

4. Past medical history

Diet:
Vitamin B1: Wernicke- Korsakoff
syndrome, polyneuropathy in alcoholics
Vi. B3: pellagra (dementia)
Vi.B12: pernicious anaemia
(megaloblastic madness).
Vi.E: spinal cord degeneration
Excessive consumption of fats: stroke
Preserved foods: botulinum toxin

4. Past medical history

Tobacco, Alcohol, other Drug
use:
Tobacco: lung cancer, may
metastasize to CNS, paraneoplastic
neurologic syndromes.
Alcoholic abuse: withdrawal seizures.
Intravenous use: HIV disease,
infection, or vasculitis.

5. Family history
1

3
A. X-linked recessive
B. Autosomal
dominant
C. Autosomal
recessive

6. Social history
Education, occupation
Sexual history: sexually transmitted
diseases (syphilis, HIV).
Travel history.

6. Review of systems

General
Immune
Hematologic
Endocrine
Skin
Eyes, ears, nose, and throat
Cardiovascular
Respiratory
Gastrointestinal
Genitourinary
Musculoskeletal
Psychiatric

Take-home message

Thank you for your attention