Participating in the session today. We covered a history station.
A 16-year-old had presented with worsening headaches for the past 2 to 3 months. Dr P did an excellent role play and was too good to offer a lot of information not requested. Dr A was in the hot seat. Most of the points in the history were covered but some important points were missed. As a whole group all was mentioned and covered.
Mistake was made of moving from H&M to Communication mode. Presented Power Point on History & Management.
- Work our differential while viewing the information and differentiating questions in 4 minutes.
- Social & family life
- Detailed current medication / drug history / compliance
- DO not move to Communication mode.
- Brief summary with + & – ve points to support your first diagnosis
- Important DD offer for discussion
- Management is a Team – effort – you do not need to manage all options
- Discuss with Consultant
- Hemiplegic Migraine is a diagnosis of exclusion by Paediatric neurologist
- Imaging with Chronic is an almost must. Can delay it till discussion with consultant.
- Do not go to Psychiatry before ruling out space occupying lesion – it may be the cause!
- Not neurological exam – does not rule out a Space Occupying Lesion
- Head smart card – check put.
Visit www.mrcpchonline.org to Add your comments or any point I have missed.