A comprehensive clinical examination is the basis for selecting further diagnostic steps:
- General physical examination – including blood pressure, pulse, body weight, height; further:
- Inspection (viewing).
- Examination of:
- Palpitation and pressure pain of the calotte.
- Trigeminal exit points
- Palpation (palpation) of the superficial temporal artery
- Eyes: bulbar pressure and movement pain.
- Cervical spine mobility [including meningismus?/painfulness and increased resistance to movements of the head in the cervical spine; due todifferential diagnosis: meningitis (meningitis), unspecified].
- Pressure pain of the pericranial muscles (mimic as well as masticatory and neck muscles).
- Pain during jaw opening
- Ophthalmic examination – including tonometry (measurement of intraocular pressure) [due todifferential diagnoses:
- Ocular migraine (synonyms: ophthalmic migraine; migraine ophtalmique) – variant of migraine in which there are transient, bilateral visual disturbances (flickering, flashes of light, scotomas (restrictions of the visual field); similar to “normal” migraine with aura); often without headache, but sometimes with headache, which sometimes occurs only after the visual disturbances; duration of symptoms usually 5-10 minutes, rarely longer than 30-60 minutes Retinal migraine, in which only the retina, i.e. the retina at the back of the eye, is affected, must be distinguished from ocular migraine. i.e., the retina at the back of the eye, is affected – variant of migraine in which completely reversible monocular (“affecting one eye”), positive and/or negative visual phenomena (flickering, scotomas, or blindness) occur; these occur together with headaches that begin while the visual disturbances are still present or follow within 60 minutes
- Glaucoma attack – eye disease with increased intraocular pressure]
- ENT examination – including inspection of nasal (accessory) cavities [due todifferential diagnoses:
- Nasal cavity tumors, unspecified.
- Paranasal sinus tumors, unspecified]
- Neurological examination – including review/examination.
- 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
- Health check
Square brackets [ ] indicate possible pathological (pathological) physical findings.
