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Evaluation

Are you evaluating a patient who has had West Nile Virus encephalitis?

Baseline score for physical health (enter from 0 to 20, with 0 normal)

out of 20

Baseline score for cognitive health (enter from 0 to 12, with 0 normal)

out of 12

Baseline score for functional health (enter from 0 to 18, with 0 normal)

out of 18

Select appropriate answer for each physical ability

Difficulty walking

Fatigue

Headache

Insomnia

Joint pain

Muscle pain

Muscle weakness

Seizures

Stiff neck

Select appropriate answer for cognitive ability

Confusion

Depression

Irritability

Lightheadedness

Loss of concentration

Loss of memory

Select appropriate answer for each functional ability

Heavy chores

Laundry

Light housekeeping

Managing medications

Managing money

Meal preparations

Shopping

Telephoning

Transportation

Results

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