Medical history (history of illness) represents an important component in the diagnosis of disorders of consciousness* .
Family History
- Are there any disorders in your family that are common?
Social history
- Is there any evidence of psychosocial stress or strain due to your family situation?
Current medical history/systemic history (somatic and psychological complaints) [third-party history, if applicable].
- What symptoms are present?
- How long have these symptoms been present?
- Did the disturbance of consciousness develop slowly or abruptly?
- Has the disturbance of consciousness changed (improved/worsened* etc.)?
- Is communication possible without change? [if no* ]
- Is there a response to pain stimuli? [if no* ]
- Have there been any changes in muscle tone/posture* ? [if yes* ]
- Are other symptoms present, such as headaches, pupillary disturbances* , paralysis* , discoloration of the skin, etc.?
- Was the disturbance of consciousness preceded by an injury* ?
- Are there any known blood sugar fluctuations?
Vegetative anamnesis incl. nutritional anamnesis.
- Has your appetite changed?
- Have you noticed any unwanted change in body weight?
- Do you suffer from sleep disturbances?
- Do you drink alcohol? If so, what drink(s) and how many glasses per day?
- Do you use drugs? If yes, what drugs and how often per day or per week?
- Do you smoke? If yes, how many cigarettes, cigars or pipes per day?
Self history including medication history.
- Pre-existing conditions (heart disease, liver disease, neurological diseases, metabolic diseases (eg, diabetes mellitus), addictive disorders).
- Operations
- Allergies
- Environmental history (poisonings of all kinds)
- Medication history
Medication
- Antiarrhythmics
- Class Ib antiarrhythmics (lidocaine).
- Antibiotics
- Quinolones/fluoroquinolones/gyrase inhibitors (ciprofloxacin, moxifloxacin, nalidixic acid, norfloxacin, lomefloxacin, levofloxacin, ofloxacin).
- Alpha-sympatholytics (phenoxybenzamine).
- Antiviral therapy (aciclovir, brivudine, cidofovir, efavirenz, famciclovir, fomivirsen, foscarnet, ganciclovir, lopinavir, rilpivirine, ritonavir, tenofovir, valganciclovir, zidovudine).
- Calcium antagonists (amlodipine, diltiazem, felodipine, fendiline, gallopamil, lacidipine, lercanidipine, nitrendipine, nifedipine, nimodipine, nicardipine, isradipine, nisoldipine, nilvadipine, manidipine, verapamil)
- Hormones
- Hypnotics
- Muscle relaxants
- Benzodiazepines (tetrazepam* ) [* prescription ban since August 2013 due to serious skin reactions such as Stevens-Johnson syndrome or erythema multiforme]
- Opiates or opioids (alfentanil, apomorphine, buprenorphine, codeine, dihydrocodeine, fentanyl, hydromorphone, loperamide, morphine, methadone, nalbuphine, naloxone, naltrexone, oxycodone, pentazocine, pethidine, piritramide, remifentanil, sufentanil, tapentadol, tilidine, tramadol).
- Parasympathomimetics
- Indirect parasympathomimetics (cholinesterase inhibitors): alkylphosphates, distigmine, donepezil, galantamine, neostigmine, physostigmine, pyridostigmine, rivastigmine, tacrine
- Sedatives
- Triptans (sumatriptan)
Environmental pollution – intoxications (poisoning).
- Poisonings as caused by:
- Alkaloids
- Alcohol
- Hypnotics
- Carbon monoxide
- Hydrocarbons (aliphatic, aromatic)
- Opiates or opioids
- Sedatives
- Hydrogen cyanide/potassium cyanide
* In the case of unclear disorders of consciousness, an immediate visit to the doctor is generally required! (Information without guarantee)
