How Tracking Neuropsychiatric Symptom Expression with a Personalized E-Diary Can Improve Diagnosis and Management

Some neurological symptoms have a well-recognized, and easily verified, neuropathological substrate. The various impairments of language and calculation are the classical examples. Other symptoms are quite ambiguous, however. Their presentation is intermittent variable and not elicitable in a doctor’s office. Their etiology and pathophysiology as a neurological condition, a psychiatric disorder, a systematic illness, an iatrogenic problem or some combination of these requires more extensive investigation. This investigation too often does not yield a satisfactory resolution and management approach. Symptoms with this ambiguous picture include sensory/motor spells, headaches, cognitive lapses, fatigue and sleep disturbances, emotional lability, and odd behavior. We present case data that show how tracking such symptoms, in correlation with life events and stress, helps to clarify the diagnosis and improves management. We describe an electronic diary tracking system with three major features: a) the creation of personalized diaries, b) the automatic graphing of symptom-event-stress correlations, and c) a web/mobile platform. []