Acute Neurologic Changes – History

Neurology, Subjective/History Elements
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Acute Neurologic Changes
Onset [text] prior to evaluation
Onset while: [text]

Key Symptoms
[select value="no|YES"] <-- Weakness [text]
[select value="no|YES"] <-- Change in sensation [text]
[select value="no|YES"] <-- Facial droop [text]
[select value="no|YES"] <-- Altered speech [text]
[select value="no|YES"] <-- Altered swallowing [text]
[select value="no|YES"] <-- Difficulty standing [text]
[select value="no|YES"] <-- Vision change [text]

Associated Symptoms
[select value="no|YES"] <-- Confusion
[select value="no|YES"] <-- Agitation
[select value="no|YES"] <-- Difficult to awaken
[select value="no|YES"] <-- Complete Loss of Consciousness (lasted [text] )
[select value="no|YES"] <-- Seizure
[select value="no|YES"] <-- Headache
[select value="no|YES"] <-- Falls [text]

Pertinent ROS
[select value="no|YES"] <-- fever
[select value="no|YES"] <-- dizziness
[select value="no|YES"] <-- chest pain
[select value="no|YES"] <-- palpitations
[select value="no|YES"] <-- shortness of breath
[select value="no|YES"] <-- cough
[select value="no|YES"] <-- nausea/vomiting
[select value="no|YES"] <-- abdominal pain
[select value="no|YES"] <-- dysuria
[select value="no|YES"] <-- urinary frequency
[select value="no|YES"] <-- rash

Pertinent PMH:
[select value="no|YES"] <-- Atrial Fibrillation
[select value="no|YES"] <-- Cerebrovascular Accident or TIA
[select value="no|YES"] <-- Dementia [text]
[select value="no|YES"] <-- Coronary Artery Disease
[select value="no|YES"] <-- Diabetes Mellitus
[select value="no|YES"] <-- Head Trauma
[select value="no|YES"] <-- Serious CNS risks (e.g. active cancer, immunosuppression, HIV)
[select value="no|YES"] <-- Migraine Headaches
[html]<hr>[/html][checkbox memo="display/hide references" name="footnotes" value=""][conditional field="footnotes" condition="(footnotes).is('')"][html]
reference: contributed by Dr. Scott Moses, creator/author of the <a href="" target="_blank">Family Practice Notebook</a>[/html][/conditional]
Acute Neurologic Changes
Onset prior to evaluation
Onset while:

Key Symptoms
<-- Weakness
<-- Change in sensation
<-- Facial droop
<-- Altered speech
<-- Altered swallowing
<-- Difficulty standing
<-- Vision change

Associated Symptoms
<-- Confusion
<-- Agitation
<-- Difficult to awaken
<-- Complete Loss of Consciousness (lasted )
<-- Seizure
<-- Headache
<-- Falls

Pertinent ROS
<-- fever
<-- dizziness
<-- chest pain
<-- palpitations
<-- shortness of breath
<-- cough
<-- nausea/vomiting
<-- abdominal pain
<-- dysuria
<-- urinary frequency
<-- rash

Pertinent PMH:
<-- Atrial Fibrillation
<-- Cerebrovascular Accident or TIA
<-- Dementia
<-- Coronary Artery Disease
<-- Diabetes Mellitus
<-- Head Trauma
<-- Serious CNS risks (e.g. active cancer, immunosuppression, HIV)
<-- Migraine Headaches

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Result - Copy and paste this output:

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