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Topographical Diagnosis Essay

Decent Essays

Chapter one

THE NEUROLOGICAL DIAGNOSIS

It is useful to think of the neurological diagnosis as a three step process. The first step is to make a topographical diagnosis, i.e. to locate the lesion that is responsible for the patient’s symptoms, because almost every neurological disorder has a tendency to occur in a specific part or parts of the nervous system. For example, the plaques of multiple sclerosis have a predilection for the visual pathways, cerebellum, brain stem and spinal cord. Therefore, localisation of a lesion to a specific part of the nervous system narrows down the number of possible diagnoses. However, since several diseases may affect the same part of the nervous system the second step involves a further diagnostic workup to differentiate between the various possible disorders. The final step is to confirm the provisional clinical diagnosis with laboratory tests.

The topographical diagnosis is made by …show more content…

Apart from few specific points, the format of taking a neurological history is similar to that of general medicine. But, in contrast to general medicine, it is often necessary to ask neurological patients, at the end of the consultation, to repeat parts of the history because inconsistencies usually suggest impairment of memory or attention. Inconsistencies in reporting the symptoms are also an important feature of functional (conversion) disorders. It is also equally important to establish what the patient exactly means when he uses ambiguous words or phrases, e.g. collapsed, felt dizzy, etc. In addition, the clinician should allow the patient to describe his symptoms without unnecessary interruptions and he should avoid asking leading questions. Enquiry should also be made about the onset, progression and course of the

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