Submitted by: John McSorley, MD, Airdrie, Alberta
To do a complete neurological assessment in 10 minutes for headaches could be a challenge even for an experienced neurologist. However, a brief screening evaluation can be attempted by asking about the onset of headache, including the:
• Nature
• Location
• Frequency
• Severity
• Accompanying features (e.g., sensitivity to light, noise, smells, and weather changes)
One should also obtain information about:
• Stress and other triggers
• Nausea
• Vomiting
• Awakenings with headaches
• Trouble with vision or weight changes
• Systemic symptoms
Ruling out focal mass lesions and inflammatory and vascular conditions is the most important task. Consequently, the screening neurological examination should focus on fundus examination, motor testing, and plantar responses. One can also obtain a lot of information from the examination of a patient’s gait.
