source: FOIAVistA/tag/r/AUTOMATED_MED_INFO_EXCHANGE-DVBA-DVBC/DVBCWCN1.m@ 628

DVBCWCN1 ;ALB/CMM CRANIAL NERVES WKS TEXT - 1 ; 6 MARCH 1997
 ;;2.7;AMIE;**12**;Apr 10, 1995
 ;
 ;
TXT ;
 ;;A.  Review of Medical Records:
 ;;
 ;;
 ;;B.  Medical History (Subjective Complaints):
 ;;
 ;;    Comment on:
 ;;    1.  If flare-ups exist, describe precipitating factors, aggravating 
 ;;        factors, alleviating factors, alleviating medications, frequency, 
 ;;        severity, duration, and whether the flare-ups include pain, 
 ;;        weakness, fatigue, or functional loss.
 ;;
 ;;
 ;;    2.  Current treatment, response, side effects.
 ;;
 ;;
 ;;C.  Physical Examination (Objective Findings):
 ;;
 ;;    Address each of the following and fully describe current findings:
 ;;    1.  Identify the nerve and the side.
 ;;
 ;;
 ;;    2.  Identify the disorder (i.e., paralysis, neuritis, neuralgia).
 ;;
 ;;
 ;;    3.  Describe in detail specific motor and sensory impairment, 
 ;;        quantifying as much as possible.
 ;;
 ;;
 ;;    4.  If smell or taste is affected, please also complete the 
 ;;        appropriate worksheet.
 ;;
 ;;
 ;;D.  Diagnostic and Clinical Tests:
 ;;
 ;;    1.  Include results of all diagnostic and clinical tests conducted
 ;;        in the examination report.
 ;;
 ;;
 ;;E.  Diagnosis:
 ;;
 ;;    1.  State etiology.
 ;;
 ;;
 ;;Signature:                             Date:
 ;;END