Gbadero D A Personal information Name Age Sex Parental information History Presenting complaints When last well Duration of symptoms arrange in chronological order Detail info regarding each complaints eg worsenedrelieved by aggravated by Has the patient experienced same before ID: 933226
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Slide1
Evaluation of Nervous System
Gbadero D.
A.
Slide2Personal information
Name
Age
Sex
Parental information
Slide3History
Presenting complaints
When last well
Duration of symptoms- arrange in chronological order
Detail info regarding each complaints e.g. worsened/relieved by aggravated by. Has the patient experienced same before? Does anyone in the family have same complaints
Slide4Important neurological symptoms
Headache
Small/big head
Vomiting
Nuchal rigidity
Irritability
Motion problems
Bulging
fontanelle
Gait anomaly
Abnormal movements; ataxia, tremors
Seizure
Vertigo
Variable loss of consciousness
Sensory functions anomalies; smelling, sight, hearing, taste and touch sensations
Paraesthesia
,
anaesthesia
, numbness
Birth marks, rash, nodules
Slide5Other historical information
Family and social history
Immunization history
Past medical history
Emphasize history related to presumed diagnosis
Slide6Review of the system
Checklist of questions to ensure that no important symptoms forgotten by mother/guardian escapes evaluation
Slide7Physical Evaluation
Level of consciousness;
Record
Glasgow
coma scoring
all the time
Memory; ante-grade and retro-grade
Sensory/motor cranial nerve evaluation
Motion evaluation; gait, tremors, ataxia make patient sit up and walk if possible
Tone and power of muscles
C
heck for spasticity and clonus
Check for Babinski response
Test for presence of meningeal irritation
Slide8Signs
Bulging fontanel
Nuchal rigidity
Fever
Vomiting
Macro/microcephaly
Kernig’s
sign
Brudzinski
sign
Gait anomaly, dyskinesia
Loss of rationality
Loss of senses
Skin rash, marks
neuro
-cutaneous syndromes
Slide9Investigations
General
E&U, LFTs, RFTs
FBC
Malaria smear
Special
Lumbar puncture and CSF examination
Endocrinology T4, T4, FSH, LH,HCG
e.t.c
X-rays of the Skull
EEG
CAT Scan
MRI
Slide10Clinical diagnosis
As always must be based on
History
P/E
Diagnosis can be confirmed by
Basic investigations
Ancillary investigation