(BQ) Part 2 book “Illustrated textbook of pediatrics” has contents: Cardiac disorders, pediatric neurology, child abuse and child protection, infectious diseases, hemato-oncologic disorder, pediatric dermatology, joint and bone disorders, drug overdoses and poisoning, and other contents. | 12 HISTORY TAKING Obtaining satisfactory history often provides better clue than examination or investigation for diagnosis and management of a neurological disease. History taking should be interactive. Doctor should cross check, whether he understood, what the patient or care giver told. Doctor should ask the patient or care giver, whether he (doctor) understood is the same as the patient told to doctor. School-age children should be given an opportunity to speak to doctor alone. History of Presenting Complaints Children may present with symptoms of following neurological conditions and disorders: • Paroxysmal episodes: Seizures, migraine • Pain: Headache (migraine) • Movement disorders: Ataxia, chorea • Altered consciousness: Intracranial infections (meningoencephalitis) • Developmental delay: Falling off from normal development [cerebral palsy (CP)] • Developmental regression: Loss of already achieved developmental skill (neurodegenerative disorders). However, the above neurological features should be obtained by taking history carefully. Doctor should listen carefully what the patient said and try to rationalize the history in a broader way before jumping to describe the complaint as a specific pathological term. For example, if the mother complains that her child falls frequently and the doctor term it as seizure disorder, dyspraxia or ataxia, then he has closed his thinking for wide range of simple nonorganic cause of balance problem including simple problem like fall due to generalized weakness. On the contrary, some parents will use ill understood misleading medical term like telling doctor that their child has absence seizure, which should be gently discouraged. For acute onset clinical problem, it is usually better to start at the beginning of the history like asking the parents when the child was reasonably well. For very long-term problem, it may be more useful to start with present situation and fill in backward. If a child of 5-year-old with CP .
