Acute Neurologic Changes – History
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 [checkbox memo="display/hide references" name="footnotes" value=""][conditional field="footnotes" condition="(footnotes).is('')"] reference: contributed by Dr. Scott Moses, creator/author of the Family Practice Notebook [link url="http://www.fpnotebook.com" memo="website"][/conditional]
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