Advertisement

Clinical History and Neurological Examination

  • A. J. Larner
Chapter

Abstract

This chapter considers important aspects in the clinical history, including single item cognitive screening questions and family history, in the diagnosis of cognitive disorders, and also examines the diagnostic utility of various “non-canonical” neurological signs (attended alone, head turning, applause, la maladie du petit papier).

Keywords

Dementia Diagnosis History Neurological signs 

References

  1. Abdo WF, van Norden AG, de Laat KF, et al. Diagnostic accuracy of the clapping test in Parkinsonian disorders. J Neurol. 2007;254:1366–9.CrossRefPubMedGoogle Scholar
  2. Abernethy Holland AJ, Larner AJ. Effects of gender on two clinical signs (attended alone and head turning) of use in the diagnosis of cognitive complaints. J Neurol Sci. 2013a;333:e295–6.CrossRefGoogle Scholar
  3. Abernethy Holland AJ, Larner AJ. Applause sign: diagnostic utility in a cognitive function clinic. J Neurol Sci. 2013b;333:e292.CrossRefGoogle Scholar
  4. Aji BM, Larner AJ. Screening for dementia: is one simple question the answer? Clin Med. 2015;15:111–2.CrossRefGoogle Scholar
  5. Aji BM, Larner AJ. Screening for dementia: single yes/no question or Likert scale? Clin Med. 2017;17:93–4.CrossRefGoogle Scholar
  6. Allison RS. The senile brain. A clinical study. London: Edward Arnold; 1962.Google Scholar
  7. Alzheimer’s Society. Dementia UK update. 2nd ed. London: Alzheimer’s Society; 2014.Google Scholar
  8. American Psychiatric Association. Diagnostic and statistical manual of mental disorders, text revision (DSM-IV-TR). 4th ed. Washington: American Psychiatric Association; 2000.Google Scholar
  9. Bonello M, Larner AJ. Applause sign: screening utility for dementia and cognitive impairment. Postgrad Med. 2016;128:250–3.CrossRefPubMedGoogle Scholar
  10. Bouchard RW, Rossor MN. Typical clinical features. In: Gauthier S, editor. Clinical diagnosis and management of Alzheimer’s disease. London: Martin Dunitz; 1996. p. 35–50.Google Scholar
  11. Burns JM, Morris JC. Mild cognitive impairment and early Alzheimer’s disease. Chichester: John Wiley; 2008.Google Scholar
  12. Campion D, Dumanchin C, Hannequin D, et al. Early-onset autosomal dominant Alzheimer disease: prevalence, genetic heterogeneity, and mutation spectrum. Am J Hum Genet. 1999;65:664–70.CrossRefPubMedPubMedCentralGoogle Scholar
  13. Commissaris CJ, Ponds RW, Jolles J. Subjective forgetfulness in a normal Dutch population: possibilities for health education and other interventions. Patient Educ Couns. 1998;34:25–32.CrossRefPubMedGoogle Scholar
  14. Creavin S, Fish M, Gallacher J, Bayer A, Ben-Shlomo Y. Clinical history for diagnosis of dementia in men: Caerphilly prospective study. Br J Gen Pract. 2015;65:e489–99.CrossRefPubMedPubMedCentralGoogle Scholar
  15. Cruts M, van Duijn CM, Backhovens H, et al. Estimation of the genetic contribution of presenilin-1 and -2 mutations in a population-based study of presenile Alzheimer disease. Hum Mol Genet. 1998;7:43–51.CrossRefPubMedGoogle Scholar
  16. Department of Health. Using the Commissioning for Quality and Innovation (CQUIN) payment framework. Guidance on the new national goals 2012–13. London: Department of Health, 2012.Google Scholar
  17. Doran M, Larner AJ. Monogenic Mendelian causes of dementia: ten-year survey of a dementia clinic. Eur J Neurol. 2009;16(suppl3):291. (abstract P1731)Google Scholar
  18. Doran M, du Plessis DG, Ghadiali EJ, Mann DMA, Pickering-Brown S, Larner AJ. Familial early-onset dementia with tau intron 10 +16 mutation with clinical features similar to those of Alzheimer disease. Arch Neurol. 2007;64:1535–9.CrossRefPubMedGoogle Scholar
  19. Dubois B, Slachevsky A, Pillon B, Beato R, Villalponda JM, Litvan I. “Applause sign” helps to discriminate PSP from FTD and PD. Neurology. 2005;64:2132–3.CrossRefPubMedGoogle Scholar
  20. Elsey C, Drew P, Jones D, et al. Towards diagnostic conversational profiles of patients presenting with dementia or functional memory disorders to memory clinics. Patient Educ Couns. 2015;98:1071–7.CrossRefPubMedGoogle Scholar
  21. Ferri R, Lanuzza B, Cosentino FI, et al. A single question for the rapid screening of restless legs syndrome in the neurological clinical practice. Eur J Neurol. 2007;14:1016–21.CrossRefPubMedGoogle Scholar
  22. Fisher CAH, Larner AJ. FAQs: memory loss. Practitioner. 2006;250(1683):14–6, 19, 21.Google Scholar
  23. Fukui T, Yamazaki R, Kinno R. Can the “head-turning sign” be a clinical marker of Alzheimer’s disease? Dement Geriatr Cogn Disord Extra. 2011;1:310–7.CrossRefGoogle Scholar
  24. Ghadiri-Sani M, Larner AJ. Head turning sign for diagnosis of dementia and mild cognitive impairment: a revalidation. J Neurol Neurosurg Psychiatry. 2013;84:e2.CrossRefGoogle Scholar
  25. Goldman JS, Farmer JM, Wood EM, et al. Comparison of family histories in FTLD subtypes and related tauopathies. Neurology. 2005;65:1817–9.CrossRefPubMedGoogle Scholar
  26. Griem J, Stone J, Carson A, Kopelman MD. Psychologic/functional forms of memory disorder. Handb Clin Neurol. 2016;139:407–17. [at 413]CrossRefPubMedGoogle Scholar
  27. Grover S. Don’t dismiss the little notes that patients bring. BMJ. 2015;350:h20.CrossRefPubMedGoogle Scholar
  28. Hancock P, Larner AJ. The diagnosis of dementia: diagnostic accuracy of an instrument measuring activities of daily living in a clinic-based population. Dement Geriatr Cogn Disord. 2007;23:133–9.CrossRefPubMedPubMedCentralGoogle Scholar
  29. Hancock P, Larner AJ. Clinical utility of Patient Health Questionnaire-9 (PHQ-9) in memory clinics. Int J Psychiatry Clin Pract. 2009a;13:188–91.CrossRefPubMedGoogle Scholar
  30. Hancock P, Larner AJ. Diagnostic utility of the Pittsburgh Sleep Quality Index in memory clinics. Int J Geriatr Psychiatry. 2009b;24:1237–41.CrossRefGoogle Scholar
  31. Hendry K, Hill E, Quinn TJ, Evans J, Stott DJ. Single screening questions for cognitive impairment in older people: a systematic review. Age Ageing. 2015;44:322–6.CrossRefPubMedGoogle Scholar
  32. Hodges JR. Cognitive assessment for clinicians. 2nd ed. Oxford: Oxford University Press; 2007.Google Scholar
  33. Hunter KM. Doctors’ stories. The narrative structure of medical knowledge. Princeton Univeristy Press: Princeton; 1991.Google Scholar
  34. Isella V, Rucci F, Traficante D, Mapelli C, Ferri F, Appollonio IM. The applause sign in cortical and cortical-subcortical dementia. J Neurol. 2013;260:1099–103.CrossRefPubMedGoogle Scholar
  35. Janssen JC, Beck JA, Campbell TA, et al. Early onset familial Alzheimer’s disease. Mutation frequency in 31 families. Neurology. 2003;60:235–9.CrossRefPubMedGoogle Scholar
  36. Kluger A, Gianutsos JG, Golomb J, et al. Patterns of motor impairment in normal aging, mild cognitive decline, and early Alzheimer’s disease. J Gerontol B Psychol Sci Soc Sci. 1997;52:28–39.CrossRefGoogle Scholar
  37. Knopman DS, DeKosky ST, Cummings JL, et al. Practice parameter: diagnosis of dementia (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2001;56:1143–53.CrossRefPubMedGoogle Scholar
  38. Kurlan R, editor. Handbook of secondary dementias. New York: Taylor and Francis; 2006.Google Scholar
  39. Larner AJ. “Who came with you?” a diagnostic observation in patients with memory problems? J Neurol Neurosurg Psychiatry. 2005a;76:1739.CrossRefPubMedPubMedCentralGoogle Scholar
  40. Larner AJ. Two simple questions in the identification of dementia. J Neurol Neurosurg Psychiatry. 2005b;76:1317. (abstract 023)CrossRefGoogle Scholar
  41. Larner AJ. Neurological signs of aging. In: Pathy MSJ, Sinclair AJ, Morley JE, editors. Principles and practice of geriatric medicine. 4th ed. Chichester: Wiley; 2006. p. 743–50.Google Scholar
  42. Larner A. Identify memory loss disorders. GP. 2007a;9(November):26–7.Google Scholar
  43. Larner AJ. Carphologia or floccillation. Adv Clin Neurosci Rehabil. 2007b;7(4):25.Google Scholar
  44. Larner AJ. Intrafamilial clinical phenotypic heterogeneity with MAPT gene splice site IVS10+16C>T mutation. J Neurol Sci. 2009a;287:253–6.CrossRefPubMedPubMedCentralGoogle Scholar
  45. Larner AJ. “Attended alone” sign: validity and reliability for the exclusion of dementia. Age Ageing. 2009b;38:476–8.CrossRefPubMedGoogle Scholar
  46. Larner AJ. An approach to the cognitively-impaired adult. 2011a. http://learning.ebrain.net/course/view.php?id=37. Accessed 07 Nov 17.
  47. Larner AJ. “Neurological literature”: Sherlock Holmes and neurology. Adv Clin Neurosci Rehabil. 2011b;11(1):20. 22Google Scholar
  48. Larner AJ. Intrafamilial clinical phenotypic heterogeneity with progranulin gene p.Glu498fs mutation. J Neurol Sci. 2012a;316:189–90.CrossRefPubMedGoogle Scholar
  49. Larner AJ. Neurological signs of ageing. In: Sinclair A, Morley JE, Vellas B, editors. Pathy’s principles and practice of geriatric medicine. 5th ed. Chichester: Wiley; 2012b. p. 609–16.Google Scholar
  50. Larner AJ. Head turning sign: pragmatic utility in clinical diagnosis of cognitive impairment. J Neurol Neurosurg Psychiatry. 2012c;83:852–3.CrossRefPubMedGoogle Scholar
  51. Larner AJ. Subjective memory complaints: is family history of dementia a risk factor? J Neurol Sci. 2013a;333:e295.CrossRefGoogle Scholar
  52. Larner AJ. Neuropsychological neurology: the neurocognitive impairments of neurological disorders. 2nd ed. Cambridge: Cambridge University Press; 2013b.CrossRefGoogle Scholar
  53. Larner AJ. Neurological signs of possible diagnostic value in the cognitive disorders clinic. Pract Neurol. 2014;14:332–5.CrossRefPubMedGoogle Scholar
  54. Larner AJ. Screening utility of the “attended alone” sign for subjective memory impairment. Alzheimer Dis Assoc Disord. 2014b;28:364–5.CrossRefPubMedGoogle Scholar
  55. Larner AJ. Three simple questions have high utility for diagnosing dementia in the primary care setting. Evid Based Ment Health. 2016a;19:e13.CrossRefPubMedGoogle Scholar
  56. Larner AJ. A dictionary of neurological signs. 4th ed. London: Springer; 2016b.CrossRefGoogle Scholar
  57. Larner AJ. Metamemory: a construct with diagnostic utility in a cognitive disorders clinic? Int J Geriatr Psychiatry. 2018;33:553–4.CrossRefPubMedPubMedCentralGoogle Scholar
  58. Larner AJ, Coles AJ, Scolding NJ, Barker RA. A-Z of neurological practice. A guide to clinical neurology. 2nd ed. London: Springer; 2011.Google Scholar
  59. Lipton AM, Marshall CD. The common sense guide to dementia for clinicians and caregivers. New York: Springer; 2013.CrossRefGoogle Scholar
  60. Luzzi S, Fabi K, Pesallaccia M, Silvestrini M, Provinciali L. Applause sign: is it really specific for Parkinsonian disorders? Evidence from cortical dementias. J Neurol Neurosurg Psychiatry. 2011;82:830–3.CrossRefPubMedGoogle Scholar
  61. Luzzi S, Fabi K, Pesallaccia M, Silvestrini M, Provinciali L. Applause sign in Alzheimer’s disease: relationships to cognitive profile and severity of illness. J Neurol. 2013;260:172–5.CrossRefPubMedGoogle Scholar
  62. McPherson S, La Rue A, Fitz A, Matsuyama S, Jarvik LF. Self-reports of memory problems in relatives of patients with probable Alzheimer’s disease. Int Psychogeriatr. 1995;7:367–76.CrossRefPubMedGoogle Scholar
  63. Nordenstrom J. Evidence-based medicine in Sherlock Holmes’ footsteps. Oxford: Blackwell; 2007.CrossRefGoogle Scholar
  64. O’Caoimh R, Timmons S, Molloy DW. Screening for mild cognitive impairment: comparison of “MCI specific” screening instruments. J Alzheimers Dis. 2016;51:619–29.CrossRefPubMedPubMedCentralGoogle Scholar
  65. Paradise MB, Glozier NS, Naismith SL, Davenport TA, Hickie IB. Subjective memory complaints, vascular risk factors and psychological distress in the middle-aged: a cross-sectional study. BMC Psychiatry. 2011;11:108.CrossRefPubMedPubMedCentralGoogle Scholar
  66. Petersen RC, Smith GE, Waring SC, Ivnik RJ, Tangalos EG, Kokmen E. Mild cognitive impairment: clinical characterization and outcome. Arch Neurol. 1999;56:303–8.CrossRefPubMedGoogle Scholar
  67. Randall A, Larner AJ. La maladie du petit papier: quantitative survey, clinical significance. J Neurol Neurosurg Psychiatry. 2016;87:e1.CrossRefGoogle Scholar
  68. Randall A, Larner AJ. La maladie du petit papier: a sign of functional cognitive disorder? Int J Geriatr Psychiatry. 2018;33:800.CrossRefPubMedGoogle Scholar
  69. Rohrer JD, Guerriero R, Vandrovcova J, et al. The heritability and genetics of frontotemporal lobar degeneration. Neurology. 2009;73:1451–6.CrossRefPubMedPubMedCentralGoogle Scholar
  70. Somme J, Gomez-Esteban JC, Tijero B, Berganzo K, Lezcano E, Zarranz JJ. The applause sign and neuropsychological profile in progressive supranuclear palsy and Parkinson’s disease. Clin Neurol Neurosurg. 2013;115:1230–3.CrossRefPubMedGoogle Scholar
  71. Soysal P, Usarel C, Ispirli G, Isik AT. Attended with and head-turning sign can be clinical markers of cognitive impairment in older adults. Int Psychogeriatr. 2017;29:1763–9.CrossRefPubMedGoogle Scholar
  72. Tabuas-Pereira M, Duraes J, Araujo R, et al. The head turning sign in Alzheimer’s disease: its relationship with cognitive impairment and CSF biomarkers. Eur J Neurol. 2016;23(Suppl1):67. (O2110)Google Scholar
  73. Tsai DH, Green RC, Benke KS, Silliman RA, Farrer LA. Predictors of subjective memory complaint in cognitively normal relatives of patients with Alzheimer’s disease. J Neuropsychiatry Clin Neurosci. 2006;18:384–8.CrossRefPubMedGoogle Scholar
  74. Waldemar G, Dubois B, Emre M, et al. Recommendations for the diagnosis and management of Alzheimer’s disease and other disorders associated with dementia. Eur J Neurol. 2007;14:e1–26.CrossRefPubMedGoogle Scholar
  75. Williamson JC, Larner AJ. Attended with and head-turning sign can be clinical markers of cognitive impairment in older adults. Int Psychogeriatr. 2018;30:(in press).Google Scholar
  76. Wu LJ, Sitburana O, Davidson A, Jankovic J. Applause sign in Parkinsonian disorders and Huntington’s disease. Mov Disord. 2008;23:2307–11.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • A. J. Larner
    • 1
  1. 1.Cognitive Function ClinicWalton Centre for Neurology and NeurosurgeryLiverpoolUK

Personalised recommendations