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Clinical Neuroanatomy, 26e
Appendix A. The Neurologic Examination
Sections: Examining Children and Adults, Examining Neonates.
Topics Discussed: neurologic examination.
Excerpt:"A complete history of the nature, onset, extent, and duration of the chief complaint and associated complaints must be taken. This should include previous diseases, personal and family history, occupational data, and social history. A complete listing of medications is essential. It may be desirable—or necessary—to interview relatives and friends.Note the duration, time of onset, location, frequency, severity, progression, precipitating circumstances, associated symptoms, and response to medications. A worsening headache, or "the worst headache of my life," is especially concerning.The patient's level of consciousness and degree of alertness should be noted. Is the patient conscious and fully alert, lethargic, stuporous, or comatose? A depressed level of consciousness can be the first clue, for example, in patients harboring subdural hematomas.As noted previously, the examiner can learn much by observing the patient's behavior, mode of speech, appearance, grooming, and degree of cooperation. Can the patient give a coherent and accurate history? Is the patient appropriately concerned about the illness? Does the patient interact appropriately with family members who are present in the examining room?
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