1. Complete medical and environmental history; medication history. Focus on exposures at home and in the workplace |
2. Thorough physical examination, including neurologic examination |
3. Mental status examination and formal psychiatric evaluation |
4. Routine laboratory studies, which may include: |
Complete blood count, with differential |
Serum electrolytes |
Serum glucose |
Blood urea nitrogen |
Creatinine |
Liver function tests |
Thyroid function tests |
Urinalysis |
Electrocardiogram |
Chest x-ray |
5. Neuropsychological testing for patients with cognitive complains (eg, memory impairment), or to rule out alternate diagnoses (eg, dementia) |
6. Immunologic tests for patients reporting allergies or immune dysfunction |
Skin tests or in vitro assays with common allergens |
Immunoglobulin levels |
Complement levels |
Selected auto-antibody assays |
Simple T- and B-cell assays |
7. Other tests will be guided by the patient's complaints (eg, spirometry for patients whose primary complaints are respiratory, nerve conduction tests for patients with persistent numbness and tingling in the extremities) |
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