PRESENTING SYMPTOMS

 

Patients present with a range of neurological symptoms. It is in fact the neurological history that is the most vital part of the neurological assessment. You will hear experienced older Neurologists saying that if they had to do away with one part of the assessment of a neurological patient, it would always be the physical examination as the history usually tells us what we are going to find on neurological examination. You will never hear a Physician or Surgeon in any other specialty make such a comment as for them, the examination is vital. The neurological history is always much longer than any other medical specialities, the exception being the history given to a Psychiatrist.

The key part of the neurological history taking process is to allow the patient time to discuss what has gone wrong. A full chronology is vital. We can identify the likely mechanism by the natural history of the symptom presentation in the same way as we can place the lesion in the nervous system usually by hearing how the body has been affected.

In terms of how symptoms present, the commonest presentation to Neurologists would be headache which would make up about one-third of any busy clinical neurology practice. Fits, faints, funny turns and dizziness would comprise a further one-third of the practice and all the other conditions such as weakness, stiffness or numbness would comprise the final third of referred patients.

My clinical websites www.neurologyclinic.co.uk and www.neurologyclinic.org.uk give I hope a good account of how we handle headache disorders and the assessment of “funny turns”.