A comprehensive clinical examination is the basis for selecting further diagnostic steps:
- General physical examination – including blood pressure, pulse, body weight, height; further:
- Ophthalmological examination – including tonometry (measurement of intraocular pressure) [due todifferential diagnosis:
- Glaucoma attack – eye disease with seizure-like increased intraocular pressure]
- ENT examination – including epipharyngoscopy (nasopharyngoscopy) and laryngoscopy (laryngoscopy) [due todifferential diagnoses:
- Chronic frontal sinusitis (sinusitis).
- Nasal cavity tumors
- Paranasal sinus tumors]
- Neurological examination – including review/examination (note: an unremarkable neurological status is essential for the diagnosis of tension headache/migraine).
- Sensorimotor function and reflexes
- Cranial nerve functions
- Paresis (paralysis)?, paresthesias (insensations)?
- Visual disturbances?, bulbar pressure?, movement pain of the eyes?
- Palpation of the trigeminal exit sites
- Mobility of the cervical spine?
- Meningismus (neck stiffness)?
- Signs of a seizure event?
- Vigilance (wakefulness)?
- Orientation, memory, mental state
- Dental examination [due todifferential diagnosis: cromandibular dysfunction – mainly caused by nocturnal teeth grinding (bruxism)].
- Health check
Square brackets [ ] indicate possible pathological (pathological) physical findings.