Diagnostic Access In Neurological Patients

In patients with neurological symptoms, the procedure after the neurological method that is used in the procedure in the following steps: identification of the anatomical location of the lesion or the symptoms causing lesions determine the pathophysiology involved creating a differential diagnosis selection of appropriate specific tests The identification of anatomy and pathophysiology of lesion by careful history taking and accurate neurological examination significantly narrows the differential diagnosis and thus the number of tests required. This approach should not be replaced by the ill-considered placement of CT, MRI and laboratory tests, because this leads to errors and unnecessary costs. To determine the anatomical position, the examiner issues such as the lesion is localized to one or more points? If the lesion limited to the nervous system or part of a systemic disease? Which part of the nervous system is affected? Specific parts of the nervous system must be taken into consideration: cortex, subcortical white matter, basal ganglia, thalamus, cerebellum, brainstem, spinal cord, brachial plexus or lumbosacral plexus, more peripheral nerves, neuromuscular junction, and musculature. After the lesion has been located, the following categories are considered by pathophysiological causes: vascular Due Infectious Neoplastic Degenerative traumatic toxic-metabolic immune mediated applied properly, the neurological method provides an orderly approach in the most complex case, and the doctor is far less by neurological mimicry deceived-z , For example, when the symptoms of acute stroke are actually due to a brain tumor or when a rapidly ascending paralysis that suggests Guillain-Barre syndrome, actually is due to spinal cord compression. History The history is the most important part of the neurological assessment. The patient should be reassured, and he should be able to tell his story in his own words. Usually a clinician can quickly decide whether such a useful history will occur, or if a family member should be consulted instead of the patient. The history of the current disease should include: clarify specific questions, the type, intensity, distribution, duration and frequency of each symptom. It should be determined, which increases the symptoms and what it softens and whether previous treatments were successful. to let describing the patient, the order in which the symptoms occur can help in determining the cause. Specific disabilities should quantitatively described (eg. As running more than 8 meters, then you have to take a break stop) and its importance for the daily life of patients are detected. All medical personal history with an overview of all body systems is due to the frequency of neurological complications in other diseases, particularly alcoholism, diabetes, malignancies, disease and HIV infection, is essential. Since migraine, many metabolic diseases, muscle, nerve and neurodegenerative syndromes are hereditary, the family history is very important. Social, labor and travel history provide information on unusual infections and exposure to toxins and parasites. Sometimes neurological symptoms are functional or psychogenic and reflect a more mental disorder. Typically, these symptoms and findings do not match the anatomical and physiological rules, and the patient is often depressed or unusually anxious. However, functional and organic disorders can coexist, and it may be difficult to distinguish them. Physical examination and tests A physical examination to assess all body systems is carried out, but the focus is on the nervous system (neurological examination). The neurological examination, which is elsewhere discussed in detail in The Moanual involves: Psychic finding cranial nerve motor system muscle power transition, state and coordination sensory reflexes Autonomic nervous system in many situations is also a cerebrovascular exam. Diagnostic tests may be needed to confirm a diagnosis or rule out other possibilities.

Health Life Media Team

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