History: Chief complaint, history of present illness, past medical history, prior surgeries, drug allergies, prescription drugs and over-the-counter medications, family history, habits and exposures, and review of systems.
General Exam: Weight, blood pressure, pulse, head, neck, heart, lungs, abdomen, and extremities.
Neurologic Exam: Mental status, cranial nerves, reflexes, motor, sensory, and coordination.
Electrophysiological Studies: Nerve Conduction Studies NCS: small nerve shocks are transmitted to skin surface electrodes over nerves or muscles. Visual Evoked Responses VER: occipital scalp electrodes measure visual stimulation response. Brain stem Auditory Evoked Responses BAER: scalp electrodes measure response to auditory stimulation.
Outside Studies and Referrals: Laboratory testing: ANA, CBC, CMP, CRP, ESR, TSH, U/A, vitamin B-12, D 25-OH. Radiology: CT, CTA, MR, MRA, radionuclide scan, ultrasound, and X-ray. Consults: Internal Medicine, Neurosurgery, Psychiatry, Psychology, Orthopedics, and Rheumatology. Referrals: Dietitian, Occupational Therapy, Physical Therapy. Second opinions: to various neurologic subspecialties at Johns Hopkins.
Counseling and Treatment:
Diet, exercise, lifestyle modification and medication for the patient, with ongoing family, primary and specialty care involvement in follow up.