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1DVBCWCN1 ;ALB/CMM CRANIAL NERVES WKS TEXT - 1 ; 6 MARCH 1997
2 ;;2.7;AMIE;**12**;Apr 10, 1995
3 ;
4 ;
5TXT ;
6 ;;A. Review of Medical Records:
7 ;;
8 ;;
9 ;;B. Medical History (Subjective Complaints):
10 ;;
11 ;; Comment on:
12 ;; 1. If flare-ups exist, describe precipitating factors, aggravating
13 ;; factors, alleviating factors, alleviating medications, frequency,
14 ;; severity, duration, and whether the flare-ups include pain,
15 ;; weakness, fatigue, or functional loss.
16 ;;
17 ;;
18 ;; 2. Current treatment, response, side effects.
19 ;;
20 ;;
21 ;;C. Physical Examination (Objective Findings):
22 ;;
23 ;; Address each of the following and fully describe current findings:
24 ;; 1. Identify the nerve and the side.
25 ;;
26 ;;
27 ;; 2. Identify the disorder (i.e., paralysis, neuritis, neuralgia).
28 ;;
29 ;;
30 ;; 3. Describe in detail specific motor and sensory impairment,
31 ;; quantifying as much as possible.
32 ;;
33 ;;
34 ;; 4. If smell or taste is affected, please also complete the
35 ;; appropriate worksheet.
36 ;;
37 ;;
38 ;;D. Diagnostic and Clinical Tests:
39 ;;
40 ;; 1. Include results of all diagnostic and clinical tests conducted
41 ;; in the examination report.
42 ;;
43 ;;
44 ;;E. Diagnosis:
45 ;;
46 ;; 1. State etiology.
47 ;;
48 ;;
49 ;;Signature: Date:
50 ;;END
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