From symptom to neurologic pattern
Connect onset, examination findings, and functional change
Clarify the event or illness, symptom course, loss of skills, fluctuation, medication and substance exposure, sleep, pain, collateral observations, and rehabilitation history. New focal findings, seizures, altered consciousness, or rapid decline require prompt medical evaluation.
- Practice context
- Outpatient, emergency, inpatient, neurology, rehabilitation, primary care, and consultation-liaison settings
- Typical pace
- Immediate escalation for acute neurologic change; longitudinal assessment and rehabilitation for persistent cognitive, emotional, or behavioral symptoms
- Who's involved
- People with TBI, post-concussive symptoms, seizures, cognitive change, focal findings, or psychiatric symptoms linked to neurologic disease
Common presentations
- Traumatic brain injury and persistent post-concussive symptoms
- Headache, dizziness, sleep disruption, fatigue, or sensory sensitivity
- Changes in attention, memory, executive function, mood, impulse control, or personality
- Seizures, seizure-like episodes, and postictal behavioral or cognitive change
- New focal deficits, movement changes, language changes, or altered awareness
- Psychiatric symptoms associated with stroke, epilepsy, neurodegenerative disease, or other neurologic conditions
PMHNP priorities
- Establish premorbid baseline, neurologic timeline, symptom trajectory, and functional impact
- Screen for red flags and arrange urgent medical or neurologic assessment when indicated
- Review medications, substances, sleep, pain, and other factors that may worsen cognition or lower seizure threshold
- Use collateral, records, neurologic examination findings, and rehabilitation data to refine the formulation
- Understand how EEG helps evaluate suspected epileptic activity and its limits when events are intermittent
- Use CT or MRI when the clinical question involves acute injury, structural disease, focal findings, or another neurologic process
- Track cognition, behavior, symptoms, and function across recovery
Care team
PMHNPs, psychiatrists, neurologists, physiatrists, emergency and primary care clinicians, neuropsychologists, radiologists, EEG technologists, nurses, pharmacists, rehabilitation therapists, speech-language pathologists, social workers, and patient-identified supports.