Adams and Victor's Principles of Neurology

 
TAKING THE HISTORY
In neurology, more than any other specialty, the physician
is dependent upon the cooperation of the patient for a reli-
able history, especially for a description of those symp-
toms that are unaccompanied by observable signs of
disease. If the symptoms are in the sensory sphere, only
the patient can tell what he* sees, hears, or feels. The first
step in the clinical encounter is to enlist the patient’s trust
and cooperation and make him realize the importance of
the history and examination procedure.
The practice of making notes at the bedside or in the
office is particularly recommended. Immediate recording
of the history assures maximal reliability. Of course, no
matter how reliable the history appears to be, verification
of the patient’s account by a knowledgeable and objective
informant is always desirable.
The following points about taking the neurologic his-
tory deserve further comment:
1. Special care must be taken to avoid suggesting to the
patient the symptoms that one seeks. Errors and
inconsistencies in the recorded history are as often the
fault of the physician as of the patient. The patient
should be discouraged from framing his symptom(s)
in terms of a diagnosis that he may have heard; rather,
Table 1-2 
 
RELATIVE PREVALENCE OF THE MAJOR NEUROLOGIC 
DISORDERS IN THE UNITED STATES
APPROXIMATE PREVALENCE
 
Degenerative diseases
Amyotrophic lateral sclerosis
5 
×
10
4
Huntington disease
5 
×
10
4
Parkinson disease
5 
×
10
6
Alzheimer disease
5 
×
10
6
Macular degeneration
5 
×
10
7
 
Autoimmune neurologic diseases
Multiple sclerosis
4 
×
10
5