Severity: / 10 , Pattern: , worse during the Worsening factors or triggers: Treatments tried: ,
General appearance:
Eyes: -R: , -L: , Ears: -R: , -L:
Heart: ,
Lungs: ,
- Mental status: , oriented in , speech - Cranial nerves:
- Strength: upper extremities -R /5 , -L /5 lower extremities -R /5 , -L /5 - Sensation: upper extremities -R , -L , lower extremities -R , -L
- Reflexes: triceps -R , -L , biceps -R , -L , brachioradialis -R , -L
patellar -R , -L , achilles -R , -L , plantar -R , -L
- Cerebellar function: , finger-nose , rapid alternating movements , heel-knee , Romberg , Dix-Hallpike , - Gait: , tandem walking , heel and toe walking
- Blood work: , , ,
- - Stress management techniques
- Avoidance of triggers (e.g. caffeine, alcohol, stress)
- Avoidance of overuse of analgesics
- Referral to neurologist
- Referral to psychologist
- Return if headaches worsen, if new symptoms develop such as vision changes or weakness, or if symptoms do not improve with treatment