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Marvix AI: The Ambient AI Revolutionizing Neurology Workflows and Documentation
Explore how ambient AI streamlines neurology workflows and boosts documentation efficiency with advanced technology solutions.
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Complete patient context
Review years of patient history in seconds with AI-generated Patient Recaps.
Prior notes, labs, imaging, medications & intake forms pulled directly from your EHR
Structured chronological summary of the patient’s clinical journey
Reduces chart review time by up to 90%
Provider-Personalized Notes
Generate documentation that matches your preferred style and structure.
Generates notes in the provider’s preferred structure, phrasing, format, and level of detail by learning from their previous notes.
Detailed HPI with neurological symptoms, clinical events & pertinent negatives
Description of the events leading to the visit
Supports 90–120 min complex neurology consults
Capture technical details
Capture specialty-specific findings across 14 neurology subspecialties.
Disease-specific documentation for epilepsy, Parkinson’s, dementia, neuro-oncology, headaches, pediatric neurology, neuropsychotherapy, neurosurgery and more
Captures specialty assessments like seizure semiology, cranial nerve exams, developmental milestones & tumor board notes
Supports new visits, follow-ups, and condition-specific consults
Every Score Captured
Automatically capture questionnaires, clinical scores, and technical evaluations.
Captures PHQ-9, PDQ-39, ASRS and other specialty questionnaires
Automatically embeds patient intake forms into documentation
Reduces chart review time by up to 90%
MDM-Backed Coding
Generate accurate, evidence-backed billing and coding.
ICD-10-CM, CPT & E/M coding with MDM rationale
Captures modifiers and add-on codes automatically
Captures modifiers and add-on codes automatically
When we looked for AI scribe vendors we went through a tedious process to find the right fit and we've found that in Marvix AI. Their software is customizable, integratable with EMR, specialist-friendly and is incredibly user friendly. They're responsive and willing to meet you where you are in today's ever changing AI landscape.
AM
Amanda McFayden
Director of Clinical Operations, DENT Neurologic Institute
Absolutely transformative! Marvix AI has literally changed my life by giving me back my most precious resource—time. I no longer spend weekends and evenings painstakingly finishing notes or writing long letters. With Marvix AI, I have my own personal scribe that seems to know me better than I know myself.
MC
Dr. Madeline Chadehumbe
CMO, Neurabilities
Marvix AI is amazing. It cuts the physician's cognitive effort by 50%. It captures details necessary for billing and documentation. I highly recommend it to all providers.
MQ
Dr. Mohammad Qasaymeh
Director of Pediatrics, DENT Neurologic Institute
Marvix AI has changed my work-life balance significantly! It's the single best advancement in charting — EVER!
TP
Tammy Pesaresi, AGPCNP-C
DENT Neurologic Institute
Pre-Visit Summaries
Complete Patient Context
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Review years of patient history in seconds with AI-generated Patient Recaps.
Prior notes, labs, imaging, medications & intake forms pulled directly from your EHR
Structured chronological summary of the patient's clinical journey
Reduces chart review time by up to 90%
Custom Clinical Notes
Provider-Personalized Note
Generate documentation that matches your preferred style and structure.
Generates notes in the provider’s preferred structure, phrasing, format, and level of detail by learning from their previous notes.
Detailed HPI with neurological symptoms, clinical events & pertinent negatives
Description of the events leading to the visit
Supports 90–120 min complex neurology consults
Built for Every Subspecialty
Capture technical details
Capture specialty-specific findings across 14 neurology subspecialties.
Disease-specific documentation for epilepsy, Parkinson's, dementia, neuro-oncology, headaches, pediatric neurology, neuropsychotherapy, neurosurgery and more
Captures specialty assessments like seizure semiology, cranial nerve exams, developmental milestones & tumor board notes
Supports new visits, follow-ups, and condition-specific consults
Questionnaires & Scores
Every Score Captured
Automatically capture questionnaires, clinical scores, and technical evaluations.
Captures PHQ-9, PDQ-39, ASRS and other specialty questionnaires
Automatically embeds patient intake forms into documentation
Generates structured summaries of technical test results
MDM-Backed Coding
Generate accurate, defensible coding backed by clear medical decision-making documentation.
ICD-10-CM, CPT & E/M coding with MDM rationale
Captures modifiers and add-on codes automatically
Reduce undercoding with evidence-backed coding
1
Before the Visit
Walk In Prepared
Marvix AI pulls years of patient history from your EHR and builds an AI Patient Recap before you enter the room.
Appointment schedule synced from your EHR
AI-generated Patient Recap summaries
Retrieves prior notes, labs, imaging and medications
Active problems and HCC recapture
Care-gap and MIPS/HEDIS alerts
Coverage and eligibility check
2
During the Visit
Complete Consult Intelligence
Ambient capture of the full neurological encounter, merged into one structured note as you speak.
Ambient note generation as you speak
Custom neurology templates per provider
Captures every clinical detail accurately
The whole care team contributes to one note
Real-time documentation nudges and missing-detail alerts
Red-flag anomaly macros for neurologic exams
3
After the Visit
Insurance-Ready Documentation
Clinical notes, coding and patient documents are generated and pushed back to your EHR in one click.
Complete clinical notes in your style
Carries forward histories and assessments from past visits
ICD-10, CPT and E/M coding with MDM rationale
Medical-necessity and LCC language for payers
AVS, referral letters and patient instructions
One-click sync into the right EHR sections with audit-ready trail
Marvix AI works alongside your existing EHR—pulling the right patient data before every visit and pushing structured documentation back into the correct sections automatically.
No manual copy-paste
No new workflows to learn
Supports FHIR, HL7, and API integrations
FROM YOUR EHR
Automatically Available
Appointments & Schedule
Prior Notes
Labs & Imaging
Medications
Intake Forms
Scanned Documents
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BACK TO YOUR EHR
Automatically Synced
Clinical Notes
ICD-10 & E/M Coding
Referral Letters
After Visit Summary (AVS)
Patient Instructions
Section-Mapped Documentation
Two-Way Sync
Real-Time Updates
No Integration Fee*
HIPAA Compliant
No middleware required
Connects with your EHR
Don't see your EHR? We can build a custom integration for your practice. Talk to us
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Don't see your EHR? We can build a custom integration for your practice. Talk to us.
Every Marvix AI note ties documentation to the codes it supports — so the level you bill is the level you can defend. If a claim is questioned, the proof is already in the note.
E/M level justified
MDM complexity, total time, and counseling are captured in the note — not bolted on after the fact.
ICD-10 to the right specificity
Seizure type, localization, and intractability are coded so claims are not downcoded or denied.
CPT & procedure codes captured
EEG, EMG/NCS, and injection procedures are pulled from the encounter — nothing missed in the chair.
Audit-ready trail
Every code links back to the exact line in the note that supports it. If a claim is questioned, the proof is already there.
HCC recapture & modifiers
Chronic conditions are recaptured for accurate HCC risk scores, with modifiers applied so nothing gets underbilled.
$262B
in claims denied annually falls into the gap between what's written and what payers require. (CAQH)
Coding
Audit-ready
E/M 99214
Established patient · moderate complexity
SUPPORTED BY
Detailed interval history (HPI, ROS, PMH)
Focused neurological examination
Moderate-complexity medical decision-making
ICD-10
G40.209 · Focal epilepsy, not intractable
G93.81 · Mesial temporal sclerosis
CPT
95816 · Routine EEG, awake & drowsy
95711 · Ambulatory EEG monitoring
HCC
HCC 51 · Epilepsy, recaptured
Modifiers
-25 · Separate E/M on procedure day
Pick a documentation type to preview what Marvix AI generates.
Chief Complaint
Progressively worsening migraine headaches over the past three years with increasing frequency, nausea, photophobia, phonophobia, and reduced response to acute medications.
History of Present Illness
Fred Harris is a 39-year-old right-handed male who presents for evaluation of worsening migraine headaches. He has a history of episodic migraine without aura dating back approximately seven years, initially experiencing one to two headaches monthly that responded well to ibuprofen. Over the past three years his headaches have gradually increased in both frequency and severity. He now experiences approximately eight to ten migraine days per month, with one to two severe attacks each week lasting 12 to 24 hours. The headaches are typically unilateral, pulsating, and centered over the right frontotemporal region, although they occasionally occur on the left. Pain is rated up to 9/10 and frequently interferes with work and daily activities.
His headaches are associated with nausea, occasional vomiting, photophobia, phonophobia, osmophobia, and worsening with routine physical activity. He denies visual aura, focal weakness, numbness, diplopia, vertigo, seizure activity, or loss of consciousness. Common triggers include inadequate sleep, prolonged computer use, emotional stress, dehydration, missed meals, and red wine. Sumatriptan provides partial relief when taken early but has become less effective over the past year, and he now uses acute headache medications approximately ten to twelve days each month. Between attacks he feels neurologically normal without persistent deficits.
Past Medical History
Current Medications
Past Surgical History
Family History
Social History
Married and works full-time as a financial analyst. Never smoked, drinks alcohol socially, and has recently begun avoiding red wine because it consistently triggers migraines. Denies illicit drug use and averages approximately six hours of sleep on work nights.
Functional Status
Activities of Daily Living (ADLs)
Instrumental Activities of Daily Living (IADLs)
Review of Systems
Vitals
Mental Status Exam
Neurological Exam
Labs & Imaging
Laboratory Tests (May 2026)
CBC and comprehensive metabolic panel within normal limits. Creatinine 0.92 mg/dL (eGFR 98), TSH 2.04, Vitamin B12 486. No metabolic abnormalities identified.
MRI Brain with and without Contrast (June 2026)
No acute intracranial abnormality. No mass, infarction, hemorrhage, hydrocephalus, or abnormal enhancement. Mild incidental maxillary sinus mucosal thickening. No structural cause for headaches identified.
Assessment
Plan
1. Episodic Migraine Without Aura
Progressive worsening of migraine frequency over three years with approximately eight to ten migraine days per month despite appropriate acute treatment. Neurological examination and MRI brain show no evidence of a secondary headache disorder. Given increasing frequency and functional impairment, preventive therapy is indicated.
2. Migraine-Related Functional Impairment
Migraine attacks are resulting in missed workdays and reduced occupational performance.
3. Risk for Medication Overuse Headache
Current acute-medication use places him at increased risk for medication overuse headache.
4. Essential Hypertension
Blood pressure remains well controlled.
Ordered
Medications
Follow Up
Follow-up in three months to assess headache frequency, medication tolerance, and response to preventive therapy. Advised to seek immediate care for any sudden thunderclap headache, persistent neurological deficits, seizure activity, or significant change in headache pattern suggestive of a secondary headache disorder.
SCROLL THE FULL NOTE
WHAT IT CAPTURES
Captures headache frequency, triggers, acute-medication use and preventive planning in one structured note.
Monthly migraine-day count and severity documented in the HPI
Triggers and acute-medication days tracked for overuse risk
Preventive and rescue plan structured automatically
Normal exam and MRI documented to exclude secondary causes
Your Workflow Stays Exactly the Same
We tailor Marvix AI to your specialty, notes workflows, and EHR.
Chief Complaint
Progressive memory loss over the past three years with increasing forgetfulness, difficulty managing daily tasks, word-finding difficulty, and concern for dementia.
History of Present Illness
Martin Summit is a 74-year-old right-handed male presenting for evaluation of progressive cognitive decline over approximately three years. His wife reports symptoms began with increasing forgetfulness, repetitive questioning and misplacing items, and have gradually progressed. Over the past year he has developed greater difficulty remembering recent conversations and appointments, managing finances, organizing medications and following multistep tasks. He occasionally loses track of dates and becomes disoriented in unfamiliar environments but remains familiar with close family and his home; his wife now pays bills and oversees his medications.
He reports occasional word-finding difficulty and slower processing but denies abrupt changes. His wife notes mild apathy and reduced interest in hobbies, without significant personality change, aggression or hallucinations. Sleep is fragmented with daytime naps. He remains independent with basic self-care but needs assistance with several IADLs. No history of stroke, seizure, head trauma, loss of consciousness or rapidly progressive decline.
Past Medical History
Current Medications
Past Surgical History
Family History
Social History
Retired accountant who lives with his wife. Never smoked, drinks alcohol occasionally, denies illicit drug use. Remains physically active with daily walks but has reduced community participation because of memory concerns.
Functional Status
Activities of Daily Living (ADLs)
Instrumental Activities of Daily Living (IADLs)
Review of Systems
Vitals
Mental Status Exam
Neurological Exam
Labs & Imaging
Laboratory Tests (June 2026)
CBC and CMP normal. Na 138, Cr 0.96 (eGFR 82), HbA1c 7.0%, B12 462, Folate 12.4, TSH 2.18. No reversible metabolic cause identified.
MRI Brain (July 2026)
Mild bilateral hippocampal volume loss with mild generalized cerebral atrophy beyond age expectation. Mild chronic microvascular white-matter changes (Fazekas 1). No acute infarct, hemorrhage, hydrocephalus or mass.
Assessment
Plan
1. Progressive Cognitive Impairment
Gradual decline in short-term memory, executive function and IADLs over three years, with impaired delayed recall and hippocampal atrophy on MRI. Presentation is most consistent with early Alzheimer's disease; formal neuropsychological testing is warranted.
2. Functional Decline
Remains independent with basic self-care but has increasing difficulty with complex tasks.
3. Cerebral Small-Vessel Disease
Mild chronic microvascular changes may contribute to cognitive dysfunction.
4. Caregiver Education
The patient's wife provides increasing assistance with daily activities.
Ordered
Medications
Procedures
Follow Up
Follow-up in six weeks after neuropsychological testing to review results, establish a definitive diagnosis, discuss treatment options and determine the need for pharmacologic therapy and additional safety planning.
WHAT IT CAPTURES
Captures cognitive scores, functional status, caregiver input and a full diagnostic workup in one structured evaluation.
MoCA score and per-domain losses recorded automatically
ADL and IADL functional status separated for staging
Caregiver observations attributed within the note
Safety, driving and advance-planning discussions logged for compliance
Your Workflow Stays Exactly the Same
We tailor Marvix AI to your specialty, notes workflows, and EHR.
Chief Complaint
Progressive cognitive decline over approximately six years, with worsening memory impairment, disorientation, behavioral changes, and functional decline.
History of Present Illness
Sabrina Rae presents for follow-up of progressive cognitive decline over approximately six years. Initial documentation in February 2020 at age 69 showed short-term memory impairment, specifically repetitive questioning and misplacing objects, with an MMSE of 27/30 and impaired delayed recall (1/3).
By July 2021 she had progressed to mild cognitive impairment with functional impact; MMSE declined to 24/30 with deficits in executive function and recall, and she had difficulty managing finances and medication adherence. Donepezil was initiated in August 2021 at 5 mg daily and titrated to 10 mg nightly by December 2021.
By 2023 documentation indicated transition into moderate dementia. A June 2023 note described impairment in instrumental activities of daily living requiring assistance with finances, medications and meal preparation. She experienced acute delirium in August 2023 with a urinary tract infection, with partial return to baseline but persistent decline afterward.
Memantine was initiated in April 2025 at 5 mg daily and titrated to 10 mg twice daily by July 2025. She currently reports worsening disorientation to time and place, saying she gets confused about where she is at times, with episodes of wandering and nighttime agitation consistent with sundowning.
She has had unintentional weight loss of approximately 4 kg over six months, decreased appetite, intermittent fatigue and occasional urinary incontinence. Cognitive symptoms include progressive memory loss, disorientation and impaired executive function. Psychiatric symptoms include apathy, irritability, intermittent visual misperceptions, possible mild hallucinations, and sleep disturbance with frequent nocturnal awakenings.
Past Medical History
Current Medications
Past Surgical History
Family History
Social History
Retired schoolteacher who lives with her daughter. No tobacco use and no current alcohol use, though previously occasional social drinking. No illicit drug use.
Functional Status
Activities of Daily Living (ADLs)
Instrumental Activities of Daily Living (IADLs)
Review of Systems
Vitals
Mental Status Exam
Neurological Exam
Labs & Imaging
Laboratory Tests (June 2026)
HbA1c 7.5%, fasting glucose 132, Na 137, K 4.1, Creatinine 1.0 (eGFR 58), Vitamin B12 388, TSH 2.36. No acute metabolic derangements.
Laboratory Tests (March 2020)
TSH 2.08, Vitamin B12 412, Folate 11.2, HbA1c 6.7%, fasting glucose 118, Na 139, K 4.2, Creatinine 0.9 (eGFR 60). No metabolic contributors identified.
MRI Brain (August 2024)
Diffuse cortical atrophy, ventricular enlargement, MTA score 3, mild periventricular white-matter hyperintensities, Fazekas Grade 1.
MRI Brain (September 2021)
Moderate bilateral hippocampal atrophy (MTA score 2) with mild diffuse cortical atrophy.
MRI Brain (April 2020)
Mild medial temporal lobe atrophy (MTA score 1). No acute infarct, hemorrhage or mass lesion.
FDG PET (November 2021)
Biparietal hypometabolism, left predominant, consistent with an Alzheimer's disease pattern.
Neuropsychological Testing (October 2022)
MoCA 18/30. Severe impairment in delayed recall (0/5), executive dysfunction, impaired visuospatial construction.
Assessment
Plan
1. Moderate to Advanced Alzheimer's Dementia
Progressive cognitive decline over six years with objective deterioration from MMSE 27 to the mid-teens, functional dependence, and neuroimaging showing progressive medial temporal and cortical atrophy. FDG PET shows temporoparietal hypometabolism supporting Alzheimer's dementia. The progressive nature and importance of supportive care were discussed.
2. Sleep Disturbance and Sundowning
Nighttime agitation and frequent nocturnal awakenings are impacting patient comfort and caregiver burden.
3. Behavioral Symptoms
Apathy, irritability, intermittent visual misperceptions and possible mild hallucinations require monitoring.
4. Safety Concerns
Cognitive decline and episodes of wandering require safety measures to prevent injury.
Ordered
Medications
Labs
Imaging
Follow Up
Follow-up scheduled in three months, or sooner if there is acute decline.
WHAT IT CAPTURES
Tracks longitudinal cognitive scores, imaging progression, behavioral symptoms and caregiver-safety planning in one note.
MMSE, MoCA and imaging trends carried forward across years
Behavioral and sundowning symptoms documented for management
Medication titration history preserved across visits
Safety measures and advance-care planning logged
Your Workflow Stays Exactly the Same
We tailor Marvix AI to your specialty, notes workflows, and EHR.
Chief Complaint
Progressive resting tremor of the right hand with slowness of movement, stiffness, and impaired dexterity over the past 18 months.
History of Present Illness
Anni Lloyd is a 67-year-old right-handed female presenting for evaluation of progressive tremor and slowing of movement. Approximately 18 months ago she first noticed an intermittent resting tremor of the right hand that gradually became more frequent. Over the past year she has developed increasing stiffness of the right arm, reduced manual dexterity, and generalized slowness affecting handwriting, buttoning clothing and food preparation. Her husband has observed reduced facial expression, softer speech, and decreased right arm swing while walking. Her handwriting has become progressively smaller and more cramped.
She denies falls but describes occasional imbalance when turning quickly and difficulty rising from low chairs. She reports constipation, diminished sense of smell for several years, and occasional vivid dreams with dream-enactment behaviors reported by her husband. She denies hallucinations, significant cognitive decline, orthostatic syncope or urinary incontinence. There is no history of dopamine-blocking medications, prior stroke, significant head trauma or toxin exposure. Symptoms have gradually progressed and are beginning to interfere with daily activities.
Past Medical History
Current Medications
Past Surgical History
Family History
Social History
Retired librarian who lives with her husband. Never smoked, drinks alcohol occasionally, denies illicit drug use. Remains physically active with daily walks but has reduced gardening because of worsening hand dexterity.
Functional Status
Activities of Daily Living (ADLs)
Instrumental Activities of Daily Living (IADLs)
Review of Systems
Vitals
Mental Status Exam
Neurological Exam
Labs & Imaging
Laboratory Tests (June 2026)
CBC and CMP within normal limits. TSH 2.16, Vitamin B12 518. No metabolic abnormalities contributing to parkinsonism.
MRI Brain (July 2026)
Mild generalized cerebral volume loss consistent with age. No acute infarction, mass, hydrocephalus or structural abnormality to explain parkinsonism. Mild chronic microvascular white-matter changes.
Assessment
Plan
1. Idiopathic Parkinson's Disease
Asymmetric resting tremor, bradykinesia, rigidity and characteristic gait changes consistent with idiopathic Parkinson's disease. Gradual onset, asymmetry, non-motor symptoms and absence of atypical features support the diagnosis. Symptoms are interfering with daily activities and dopaminergic therapy is appropriate.
2. Motor Symptoms
Bradykinesia and rigidity are impairing dexterity and slowing daily activities.
3. Non-Motor Symptoms
Constipation and probable REM sleep behavior disorder are common non-motor manifestations.
4. Long-Term Disease Management
Parkinson's disease is a chronic progressive disorder requiring ongoing symptom monitoring and medication adjustment.
Ordered
Medications
Referrals
Follow Up
Follow-up in six weeks to assess response to carbidopa-levodopa, medication tolerance and need for dose adjustment. Advised to report any worsening balance, frequent falls, hallucinations, significant orthostatic symptoms or new neurological changes before the scheduled visit.
WHAT IT CAPTURES
Documents motor and non-motor features, exam findings and dopaminergic therapy initiation in a movement-disorder format.
Resting tremor, rigidity and bradykinesia captured per side
Non-motor symptoms documented alongside motor findings
Levodopa initiation and titration plan structured automatically
Gait and postural-instability exam findings recorded
Your Workflow Stays Exactly the Same
We tailor Marvix AI to your specialty, notes workflows, and EHR.
Chief Complaint
Follow-up for relapsing-remitting multiple sclerosis with evaluation of disease stability, persistent lower-extremity numbness, fatigue, and gait impairment.
History of Present Illness
Calvin Perry is a 42-year-old male returning for routine follow-up of relapsing-remitting multiple sclerosis, diagnosed in 2018 after an episode of right optic neuritis and MRI demonstrating multifocal demyelinating lesions. He has remained on ocrelizumab with good disease control and no confirmed relapses over the past two years. His vision recovered substantially, although he continues to notice mild visual fatigue after prolonged reading.
Since his last visit six months ago he denies new focal deficits, acute vision loss, diplopia, limb weakness, bowel or bladder dysfunction, or sensory level suggestive of relapse. He continues to experience chronic numbness and tingling of the left lower leg and foot, mild morning stiffness in both legs, and fatigue that worsens later in the day. He reports occasional imbalance on uneven surfaces but no falls. He remains independent in all basic ADLs and works full-time, with fatigue occasionally limiting endurance. He reports good adherence to ocrelizumab infusions without reactions or significant infections.
Past Medical History
Current Medications
Past Surgical History
Family History
Social History
Married and lives with his wife and two children. Works full-time as a software engineer. Never smoked, drinks alcohol occasionally, denies recreational drug use. Exercises regularly with stretching and low-impact aerobic activity and remains compliant with physical therapy home exercises.
Functional Status
Activities of Daily Living (ADLs)
Instrumental Activities of Daily Living (IADLs)
Review of Systems
Vitals
Mental Status Exam
Neurological Exam
Labs & Imaging
Laboratory Tests (June 2026)
CBC and CMP within normal limits. Creatinine 0.94 (eGFR 96). AST 20, ALT 24. IgG within normal range. Vitamin D 42.
MRI Brain and Cervical Spine with and without Contrast (May 2026)
Stable supratentorial and periventricular demyelinating plaques without new T2 or gadolinium-enhancing lesions. Stable cervical cord lesion at C3-C4. No active demyelination or disease progression compared with prior imaging.
Assessment
Plan
1. Relapsing-Remitting Multiple Sclerosis
Clinically stable without relapse since the previous visit. MRI shows no new or enhancing lesions and the neurological exam is unchanged, supporting continued disease stability on ocrelizumab.
2. Lower-Extremity Spasticity and Sensory Symptoms
Mild stiffness and chronic sensory deficits remain stable without functional progression.
3. MS-Related Fatigue
Fatigue remains a limiting chronic symptom but has been stable.
4. Mild Urinary Urgency
Symptoms are intermittent without retention or recurrent infection.
5. Vitamin D Replacement
Level has improved and remains in target range.
Ordered
Labs
Follow Up
Follow-up in six months following his next ocrelizumab infusion, or sooner if he develops new neurological symptoms including vision loss, limb weakness, worsening sensory deficits, gait deterioration, bowel or bladder dysfunction, or symptoms concerning for an acute MS relapse.
WHAT IT CAPTURES
Documents relapse history, imaging stability and disease-modifying therapy in a surveillance-ready note.
Relapse status and neurological exam captured each visit
MRI stability and enhancing-lesion status documented
Ocrelizumab adherence and monitoring labs tracked
Spasticity, fatigue and bladder symptoms managed in the plan
Your Workflow Stays Exactly the Same
We tailor Marvix AI to your specialty, notes workflows, and EHR.
Chief Complaint
Follow-up for ischemic stroke with evaluation of residual left-sided weakness, gait impairment, and secondary stroke prevention.
History of Present Illness
Bob Walker is a 68-year-old right-handed male returning for routine follow-up after a right middle cerebral artery ischemic stroke sustained approximately nine months ago. He initially presented with acute left-sided weakness, facial droop and dysarthria and underwent timely thrombolytic therapy followed by inpatient rehabilitation. Since his last neurology visit four months ago, he reports gradual improvement in strength and endurance through continued outpatient physical and occupational therapy. He has regained independence with most daily activities but continues to have mild weakness and decreased dexterity of the left hand, with fatigue after prolonged walking.
He denies recurrent episodes of sudden weakness, numbness, speech difficulty, vision loss, dizziness or loss of consciousness since his previous visit. His wife reports his speech has returned to baseline with only occasional word-finding difficulty when fatigued. He ambulates independently indoors but occasionally uses a cane for longer distances due to mild gait instability. He remains compliant with anticoagulation, high-intensity statin therapy, antihypertensives and home exercises, without falls, bleeding complications or adverse effects.
Past Medical History
Current Medications
Past Surgical History
Family History
Social History
Retired construction supervisor who lives with his wife. Quit smoking following his stroke after a 30-pack-year history. Drinks alcohol rarely and denies illicit drug use. Remains active with daily walking and continues prescribed home rehabilitation exercises.
Functional Status
Activities of Daily Living (ADLs)
Instrumental Activities of Daily Living (IADLs)
Review of Systems
Vitals
Mental Status Exam
Neurological Exam
Labs & Imaging
Laboratory Tests (June 2026)
CBC and CMP within normal limits. LDL 61. HbA1c 6.8%. Creatinine 0.98 (eGFR 81). No significant metabolic abnormalities.
MRI Brain (October 2025)
Chronic right MCA territory infarction involving the right frontal and parietal regions with expected encephalomalacia and gliosis. No acute infarction or hemorrhage.
CTA Head and Neck (October 2025)
Mild bilateral carotid atherosclerotic plaque without hemodynamically significant stenosis. Intracranial circulation patent without occlusion or aneurysm.
Echocardiogram (October 2025)
Normal left ventricular systolic function, ejection fraction 60%. Mild left atrial enlargement. No intracardiac thrombus.
Assessment
Plan
1. Right MCA Ischemic Stroke
Gradual neurological recovery continues following the right MCA infarction. Residual deficits are mild, primarily left-sided strength, dexterity and gait, without recurrent events. The exam is stable and functional gains continue through rehabilitation.
2. Secondary Stroke Prevention
Compliant with evidence-based prevention and good control of vascular risk factors.
3. Residual Gait and Upper-Extremity Deficits
Residual weakness continues to improve but remains noticeable during prolonged activity and fine motor tasks.
4. Long-Term Monitoring
Remains at elevated risk for recurrent events given vascular risk factors and atrial fibrillation.
Follow Up
Follow-up in six months to reassess neurological recovery, functional status and secondary stroke prevention. Instructed to seek emergency care for any sudden weakness, numbness, facial droop, speech difficulty, vision loss, severe dizziness or other symptoms concerning for recurrent stroke.
WHAT IT CAPTURES
Tracks recovery, residual deficits, secondary-prevention therapy and rehab referrals after ischemic stroke.
Residual deficits and focused exam recorded at follow-up
Anticoagulation and secondary-prevention meds documented
Rehabilitation progress and referrals carried forward
Vascular risk-factor control summarized for the chart
Your Workflow Stays Exactly the Same
We tailor Marvix AI to your specialty, notes workflows, and EHR.
Chief Complaint
Follow-up for amyotrophic lateral sclerosis with progressive upper and lower extremity weakness, dysarthria, gait decline, and evaluation of respiratory and nutritional status.
History of Present Illness
Sara Boone is a 58-year-old female returning for follow-up of limb-onset amyotrophic lateral sclerosis, diagnosed approximately two years ago after progressive right-hand weakness, EMG demonstrating widespread active and chronic denervation, and exclusion of ALS mimics. Since her last visit four months ago she reports gradual progression of weakness in both upper extremities and increasing fatigue with daily activities. She now requires additional time for dressing, grooming and meal preparation because of reduced hand strength and fine motor control, and has increasing difficulty climbing stairs and rising from low chairs, though she continues to ambulate independently for short distances at home.
Her speech has become mildly more slurred over the past several months, particularly when fatigued. She occasionally coughs while drinking thin liquids but denies recurrent aspiration pneumonia or significant weight loss. She reports intermittent calf and hand cramps, diffuse fasciculations and morning fatigue. She has mild exertional shortness of breath but denies orthopnea, morning headaches or daytime hypersomnolence. She remains compliant with riluzole and edaravone and continues multidisciplinary ALS clinic visits, speech therapy and physical therapy.
Past Medical History
Current Medications
Past Surgical History
Family History
Social History
Married and lives with her husband, who assists with several household activities. Retired elementary school teacher. Never smoked, drinks alcohol rarely, denies illicit drug use. Remains engaged in outpatient physical therapy and performs daily stretching at home.
Functional Status
Activities of Daily Living (ADLs)
Instrumental Activities of Daily Living (IADLs)
Review of Systems
Vitals
Mental Status Exam
Neurological Exam
Labs & Imaging
Laboratory Tests (June 2026)
CBC and CMP within normal limits. AST 28, ALT 31. Creatinine 0.82 (eGFR 88). Liver function stable on riluzole.
Pulmonary Function Testing (June 2026)
Forced vital capacity 74% predicted, decreased from 81% six months earlier. Maximal inspiratory pressure mildly reduced.
Electromyography (April 2024)
Widespread active and chronic denervation affecting bulbar, cervical, thoracic and lumbosacral segments, consistent with motor neuron disease.
Assessment
Plan
1. Amyotrophic Lateral Sclerosis
Expected gradual progression of limb-onset ALS with increasing upper-extremity weakness, gait impairment and mild bulbar involvement. Combined upper and lower motor neuron findings without sensory abnormalities. Functionally independent for most basic activities but needs increasing assistance with demanding tasks.
2. Bulbar Dysfunction
Increasing dysarthria and intermittent coughing with thin liquids raise concern for progressive bulbar involvement.
3. Respiratory Function
Pulmonary function testing shows a mild decline in forced vital capacity.
4. Mobility and Muscle Spasticity
Progressive weakness and spasticity continue to affect gait and upper-extremity function.
5. Advance Care Planning
The progressive nature of ALS and future care needs were reviewed with the patient and her husband.
Ordered
Procedures
Follow Up
Follow-up in three months through the multidisciplinary ALS clinic to reassess motor function, bulbar symptoms, respiratory and nutritional status and functional independence. Advised to seek prompt evaluation for rapidly worsening weakness, increasing swallowing difficulty, recurrent aspiration, significant weight loss or progressive shortness of breath.
WHAT IT CAPTURES
Consolidates motor findings, bulbar and respiratory status, and multidisciplinary planning into one ALS note.
Motor findings and FVC trend captured to stage progression
Bulbar and swallowing symptoms documented for monitoring
Riluzole and edaravone therapy tracked over time
Advance-care and ventilation discussions recorded
Your Workflow Stays Exactly the Same
We tailor Marvix AI to your specialty, notes workflows, and EHR.
Chief Complaint
Progressively worsening migraine headaches over the past three years with increasing frequency, nausea, photophobia, phonophobia, and reduced response to acute medications.
History of Present Illness
Fred Harris is a 39-year-old right-handed male who presents for evaluation of worsening migraine headaches. He has a history of episodic migraine without aura dating back approximately seven years, initially experiencing one to two headaches monthly that responded well to ibuprofen. Over the past three years his headaches have gradually increased in both frequency and severity. He now experiences approximately eight to ten migraine days per month, with one to two severe attacks each week lasting 12 to 24 hours. The headaches are typically unilateral, pulsating, and centered over the right frontotemporal region, although they occasionally occur on the left. Pain is rated up to 9/10 and frequently interferes with work and daily activities.
His headaches are associated with nausea, occasional vomiting, photophobia, phonophobia, osmophobia, and worsening with routine physical activity. He denies visual aura, focal weakness, numbness, diplopia, vertigo, seizure activity, or loss of consciousness. Common triggers include inadequate sleep, prolonged computer use, emotional stress, dehydration, missed meals, and red wine. Sumatriptan provides partial relief when taken early but has become less effective over the past year, and he now uses acute headache medications approximately ten to twelve days each month. Between attacks he feels neurologically normal without persistent deficits.
Past Medical History
Current Medications
Past Surgical History
Family History
Social History
Married and works full-time as a financial analyst. Never smoked, drinks alcohol socially, and has recently begun avoiding red wine because it consistently triggers migraines. Denies illicit drug use and averages approximately six hours of sleep on work nights.
Functional Status
Activities of Daily Living (ADLs)
Instrumental Activities of Daily Living (IADLs)
Review of Systems
Vitals
Mental Status Exam
Neurological Exam
Laboratory Tests (May 2026)
Labs & Imaging
CBC and comprehensive metabolic panel within normal limits. Creatinine 0.92 mg/dL (eGFR 98), TSH 2.04, Vitamin B12 486. No metabolic abnormalities identified.
MRI Brain with and without Contrast (June 2026)
No acute intracranial abnormality. No mass, infarction, hemorrhage, hydrocephalus, or abnormal enhancement. Mild incidental maxillary sinus mucosal thickening. No structural cause for headaches identified.
Assessment
Plan
1. Episodic Migraine Without Aura
Progressive worsening of migraine frequency over three years with approximately eight to ten migraine days per month despite appropriate acute treatment. Neurological examination and MRI brain show no evidence of a secondary headache disorder. Given increasing frequency and functional impairment, preventive therapy is indicated.
2. Migraine-Related Functional Impairment
Migraine attacks are resulting in missed workdays and reduced occupational performance.
3. Risk for Medication Overuse Headache
Current acute-medication use places him at increased risk for medication overuse headache.
4. Essential Hypertension
Blood pressure remains well controlled.
Ordered
Medications
Follow Up
Follow-up in three months to assess headache frequency, medication tolerance, and response to preventive therapy. Advised to seek immediate care for any sudden thunderclap headache, persistent neurological deficits, seizure activity, or significant change in headache pattern suggestive of a secondary headache disorder.
Chief Complaint
Progressive memory loss over the past three years with increasing forgetfulness, difficulty managing daily tasks, word-finding difficulty, and concern for dementia.
History of Present Illness
Martin Summit is a 74-year-old right-handed male presenting for evaluation of progressive cognitive decline over approximately three years. His wife reports symptoms began with increasing forgetfulness, repetitive questioning and misplacing items, and have gradually progressed. Over the past year he has developed greater difficulty remembering recent conversations and appointments, managing finances, organizing medications and following multistep tasks. He occasionally loses track of dates and becomes disoriented in unfamiliar environments but remains familiar with close family and his home; his wife now pays bills and oversees his medications.
He reports occasional word-finding difficulty and slower processing but denies abrupt changes. His wife notes mild apathy and reduced interest in hobbies, without significant personality change, aggression or hallucinations. Sleep is fragmented with daytime naps. He remains independent with basic self-care but needs assistance with several IADLs. No history of stroke, seizure, head trauma, loss of consciousness or rapidly progressive decline.
Past Medical History
Current Medications
Past Surgical History
Family History
Social History
Retired accountant who lives with his wife. Never smoked, drinks alcohol occasionally, denies illicit drug use. Remains physically active with daily walks but has reduced community participation because of memory concerns.
Functional Status
Activities of Daily Living (ADLs)
Instrumental Activities of Daily Living (IADLs)
Review of Systems
Vitals
Mental Status Exam
Neurological Exam
Labs & Imaging
Laboratory Tests (June 2026)
CBC and CMP normal. Na 138, Cr 0.96 (eGFR 82), HbA1c 7.0%, B12 462, Folate 12.4, TSH 2.18. No reversible metabolic cause identified.
MRI Brain (July 2026)
Mild bilateral hippocampal volume loss with mild generalized cerebral atrophy beyond age expectation. Mild chronic microvascular white-matter changes (Fazekas 1). No acute infarct, hemorrhage, hydrocephalus or mass.
Assessment
Plan
1. Progressive Cognitive Impairment
Gradual decline in short-term memory, executive function and IADLs over three years, with impaired delayed recall and hippocampal atrophy on MRI. Presentation is most consistent with early Alzheimer's disease; formal neuropsychological testing is warranted.
2. Functional Decline
Remains independent with basic self-care but has increasing difficulty with complex tasks.
3. Cerebral Small-Vessel Disease
Mild chronic microvascular changes may contribute to cognitive dysfunction.
4. Caregiver Education
The patient's wife provides increasing assistance with daily activities.
Ordered
Medications
Procedures
Follow Up
Follow-up in six weeks after neuropsychological testing to review results, establish a definitive diagnosis, discuss treatment options and determine the need for pharmacologic therapy and additional safety planning.
Chief Complaint
Progressive cognitive decline over approximately six years, with worsening memory impairment, disorientation, behavioral changes, and functional decline.
History of Present Illness
Sabrina Rae presents for follow-up of progressive cognitive decline over approximately six years. Initial documentation in February 2020 at age 69 showed short-term memory impairment, specifically repetitive questioning and misplacing objects, with an MMSE of 27/30 and impaired delayed recall (1/3).
By July 2021 she had progressed to mild cognitive impairment with functional impact; MMSE declined to 24/30 with deficits in executive function and recall, and she had difficulty managing finances and medication adherence. Donepezil was initiated in August 2021 at 5 mg daily and titrated to 10 mg nightly by December 2021.
By 2023 documentation indicated transition into moderate dementia. A June 2023 note described impairment in instrumental activities of daily living requiring assistance with finances, medications and meal preparation. She experienced acute delirium in August 2023 with a urinary tract infection, with partial return to baseline but persistent decline afterward.
Memantine was initiated in April 2025 at 5 mg daily and titrated to 10 mg twice daily by July 2025. She currently reports worsening disorientation to time and place, saying she gets confused about where she is at times, with episodes of wandering and nighttime agitation consistent with sundowning.
She has had unintentional weight loss of approximately 4 kg over six months, decreased appetite, intermittent fatigue and occasional urinary incontinence. Cognitive symptoms include progressive memory loss, disorientation and impaired executive function. Psychiatric symptoms include apathy, irritability, intermittent visual misperceptions, possible mild hallucinations, and sleep disturbance with frequent nocturnal awakenings.
Past Medical History
Current Medications
Past Surgical History
Family History
Social History
Retired schoolteacher who lives with her daughter. No tobacco use and no current alcohol use, though previously occasional social drinking. No illicit drug use.
Functional Status
Activities of Daily Living (ADLs)
Instrumental Activities of Daily Living (IADLs)
Review of Systems
Vitals
Mental Status Exam
Neurological Exam
Labs & Imaging
Laboratory Tests (June 2026)
HbA1c 7.5%, fasting glucose 132, Na 137, K 4.1, Creatinine 1.0 (eGFR 58), Vitamin B12 388, TSH 2.36. No acute metabolic derangements.
Laboratory Tests (March 2020)
TSH 2.08, Vitamin B12 412, Folate 11.2, HbA1c 6.7%, fasting glucose 118, Na 139, K 4.2, Creatinine 0.9 (eGFR 60). No metabolic contributors identified.
MRI Brain (August 2024)
Diffuse cortical atrophy, ventricular enlargement, MTA score 3, mild periventricular white-matter hyperintensities, Fazekas Grade 1.
MRI Brain (September 2021)
Moderate bilateral hippocampal atrophy (MTA score 2) with mild diffuse cortical atrophy.
MRI Brain (April 2020)
Mild medial temporal lobe atrophy (MTA score 1). No acute infarct, hemorrhage or mass lesion.
FDG PET (November 2021)
Biparietal hypometabolism, left predominant, consistent with an Alzheimer's disease pattern.
Neuropsychological Testing (October 2022)
MoCA 18/30. Severe impairment in delayed recall (0/5), executive dysfunction, impaired visuospatial construction.
Assessment
Plan
1. Moderate to Advanced Alzheimer's Dementia
Progressive cognitive decline over six years with objective deterioration from MMSE 27 to the mid-teens, functional dependence, and neuroimaging showing progressive medial temporal and cortical atrophy. FDG PET shows temporoparietal hypometabolism supporting Alzheimer's dementia. The progressive nature and importance of supportive care were discussed.
2. Sleep Disturbance and Sundowning
Nighttime agitation and frequent nocturnal awakenings are impacting patient comfort and caregiver burden.
3. Behavioral Symptoms
Apathy, irritability, intermittent visual misperceptions and possible mild hallucinations require monitoring.
4. Safety Concerns
Cognitive decline and episodes of wandering require safety measures to prevent injury.
Ordered
Medications
Labs
Imaging
Follow Up
Follow-up scheduled in three months, or sooner if there is acute decline.
Chief Complaint
Progressive resting tremor of the right hand with slowness of movement, stiffness, and impaired dexterity over the past 18 months.
History of Present Illness
Anni Lloyd is a 67-year-old right-handed female presenting for evaluation of progressive tremor and slowing of movement. Approximately 18 months ago she first noticed an intermittent resting tremor of the right hand that gradually became more frequent. Over the past year she has developed increasing stiffness of the right arm, reduced manual dexterity, and generalized slowness affecting handwriting, buttoning clothing and food preparation. Her husband has observed reduced facial expression, softer speech, and decreased right arm swing while walking. Her handwriting has become progressively smaller and more cramped.
She denies falls but describes occasional imbalance when turning quickly and difficulty rising from low chairs. She reports constipation, diminished sense of smell for several years, and occasional vivid dreams with dream-enactment behaviors reported by her husband. She denies hallucinations, significant cognitive decline, orthostatic syncope or urinary incontinence. There is no history of dopamine-blocking medications, prior stroke, significant head trauma or toxin exposure. Symptoms have gradually progressed and are beginning to interfere with daily activities.
Past Medical History
Current Medications
Past Surgical History
Family History
Social History
Retired librarian who lives with her husband. Never smoked, drinks alcohol occasionally, denies illicit drug use. Remains physically active with daily walks but has reduced gardening because of worsening hand dexterity.
Functional Status
Activities of Daily Living (ADLs)
Instrumental Activities of Daily Living (IADLs)
Review of Systems
Vitals
Mental Status Exam
Neurological Exam
Labs & Imaging
Laboratory Tests (June 2026)
CBC and CMP within normal limits. TSH 2.16, Vitamin B12 518. No metabolic abnormalities contributing to parkinsonism.
MRI Brain (July 2026)
Mild generalized cerebral volume loss consistent with age. No acute infarction, mass, hydrocephalus or structural abnormality to explain parkinsonism. Mild chronic microvascular white-matter changes.
Assessment
Plan
1. Idiopathic Parkinson's Disease
Asymmetric resting tremor, bradykinesia, rigidity and characteristic gait changes consistent with idiopathic Parkinson's disease. Gradual onset, asymmetry, non-motor symptoms and absence of atypical features support the diagnosis. Symptoms are interfering with daily activities and dopaminergic therapy is appropriate.
2. Motor Symptoms
Bradykinesia and rigidity are impairing dexterity and slowing daily activities.
3. Non-Motor Symptoms
Constipation and probable REM sleep behavior disorder are common non-motor manifestations.
4. Long-Term Disease Management
Parkinson's disease is a chronic progressive disorder requiring ongoing symptom monitoring and medication adjustment.
Ordered
Medications
Referrals
Follow Up
Follow-up in six weeks to assess response to carbidopa-levodopa, medication tolerance and need for dose adjustment. Advised to report any worsening balance, frequent falls, hallucinations, significant orthostatic symptoms or new neurological changes before the scheduled visit.
Chief Complaint
Follow-up for relapsing-remitting multiple sclerosis with evaluation of disease stability, persistent lower-extremity numbness, fatigue, and gait impairment.
History of Present Illness
Calvin Perry is a 42-year-old male returning for routine follow-up of relapsing-remitting multiple sclerosis, diagnosed in 2018 after an episode of right optic neuritis and MRI demonstrating multifocal demyelinating lesions. He has remained on ocrelizumab with good disease control and no confirmed relapses over the past two years. His vision recovered substantially, although he continues to notice mild visual fatigue after prolonged reading.
Since his last visit six months ago he denies new focal deficits, acute vision loss, diplopia, limb weakness, bowel or bladder dysfunction, or sensory level suggestive of relapse. He continues to experience chronic numbness and tingling of the left lower leg and foot, mild morning stiffness in both legs, and fatigue that worsens later in the day. He reports occasional imbalance on uneven surfaces but no falls. He remains independent in all basic ADLs and works full-time, with fatigue occasionally limiting endurance. He reports good adherence to ocrelizumab infusions without reactions or significant infections.
Past Medical History
Current Medications
Past Surgical History
Family History
Social History
Married and lives with his wife and two children. Works full-time as a software engineer. Never smoked, drinks alcohol occasionally, denies recreational drug use. Exercises regularly with stretching and low-impact aerobic activity and remains compliant with physical therapy home exercises.
Functional Status
Activities of Daily Living (ADLs)
Instrumental Activities of Daily Living (IADLs)
Review of Systems
Vitals
Mental Status Exam
Neurological Exam
Labs & Imaging
Laboratory Tests (June 2026)
CBC and CMP within normal limits. Creatinine 0.94 (eGFR 96). AST 20, ALT 24. IgG within normal range. Vitamin D 42.
MRI Brain and Cervical Spine with and without Contrast (May 2026)
Stable supratentorial and periventricular demyelinating plaques without new T2 or gadolinium-enhancing lesions. Stable cervical cord lesion at C3-C4. No active demyelination or disease progression compared with prior imaging.
Assessment
Plan
1. Relapsing-Remitting Multiple Sclerosis
Clinically stable without relapse since the previous visit. MRI shows no new or enhancing lesions and the neurological exam is unchanged, supporting continued disease stability on ocrelizumab.
2. Lower-Extremity Spasticity and Sensory Symptoms
Mild stiffness and chronic sensory deficits remain stable without functional progression.
3. MS-Related Fatigue
Fatigue remains a limiting chronic symptom but has been stable.
4. Mild Urinary Urgency
Symptoms are intermittent without retention or recurrent infection.
5. Vitamin D Replacement
Level has improved and remains in target range.
Ordered
Labs
Follow Up
Follow-up in six months following his next ocrelizumab infusion, or sooner if he develops new neurological symptoms including vision loss, limb weakness, worsening sensory deficits, gait deterioration, bowel or bladder dysfunction, or symptoms concerning for an acute MS relapse.
Chief Complaint
Follow-up for ischemic stroke with evaluation of residual left-sided weakness, gait impairment, and secondary stroke prevention.
History of Present Illness
Bob Walker is a 68-year-old right-handed male returning for routine follow-up after a right middle cerebral artery ischemic stroke sustained approximately nine months ago. He initially presented with acute left-sided weakness, facial droop and dysarthria and underwent timely thrombolytic therapy followed by inpatient rehabilitation. Since his last neurology visit four months ago, he reports gradual improvement in strength and endurance through continued outpatient physical and occupational therapy. He has regained independence with most daily activities but continues to have mild weakness and decreased dexterity of the left hand, with fatigue after prolonged walking.
He denies recurrent episodes of sudden weakness, numbness, speech difficulty, vision loss, dizziness or loss of consciousness since his previous visit. His wife reports his speech has returned to baseline with only occasional word-finding difficulty when fatigued. He ambulates independently indoors but occasionally uses a cane for longer distances due to mild gait instability. He remains compliant with anticoagulation, high-intensity statin therapy, antihypertensives and home exercises, without falls, bleeding complications or adverse effects.
Past Medical History
Current Medications
Past Surgical History
Family History
Social History
Retired construction supervisor who lives with his wife. Quit smoking following his stroke after a 30-pack-year history. Drinks alcohol rarely and denies illicit drug use. Remains active with daily walking and continues prescribed home rehabilitation exercises.
Functional Status
Activities of Daily Living (ADLs)
Instrumental Activities of Daily Living (IADLs)
Review of Systems
Vitals
Mental Status Exam
Neurological Exam
Labs & Imaging
Laboratory Tests (June 2026)
CBC and CMP within normal limits. LDL 61. HbA1c 6.8%. Creatinine 0.98 (eGFR 81). No significant metabolic abnormalities.
MRI Brain (October 2025)
Chronic right MCA territory infarction involving the right frontal and parietal regions with expected encephalomalacia and gliosis. No acute infarction or hemorrhage.
CTA Head and Neck (October 2025)
Mild bilateral carotid atherosclerotic plaque without hemodynamically significant stenosis. Intracranial circulation patent without occlusion or aneurysm.
Echocardiogram (October 2025)
Normal left ventricular systolic function, ejection fraction 60%. Mild left atrial enlargement. No intracardiac thrombus.
Assessment
Plan
1. Right MCA Ischemic Stroke
Gradual neurological recovery continues following the right MCA infarction. Residual deficits are mild, primarily left-sided strength, dexterity and gait, without recurrent events. The exam is stable and functional gains continue through rehabilitation.
2. Secondary Stroke Prevention
Compliant with evidence-based prevention and good control of vascular risk factors.
3. Residual Gait and Upper-Extremity Deficits
Residual weakness continues to improve but remains noticeable during prolonged activity and fine motor tasks.
4. Long-Term Monitoring
Remains at elevated risk for recurrent events given vascular risk factors and atrial fibrillation.
Follow Up
Follow-up in six months to reassess neurological recovery, functional status and secondary stroke prevention. Instructed to seek emergency care for any sudden weakness, numbness, facial droop, speech difficulty, vision loss, severe dizziness or other symptoms concerning for recurrent stroke.
Chief Complaint
Follow-up for amyotrophic lateral sclerosis with progressive upper and lower extremity weakness, dysarthria, gait decline, and evaluation of respiratory and nutritional status.
History of Present Illness
Sara Boone is a 58-year-old female returning for follow-up of limb-onset amyotrophic lateral sclerosis, diagnosed approximately two years ago after progressive right-hand weakness, EMG demonstrating widespread active and chronic denervation, and exclusion of ALS mimics. Since her last visit four months ago she reports gradual progression of weakness in both upper extremities and increasing fatigue with daily activities. She now requires additional time for dressing, grooming and meal preparation because of reduced hand strength and fine motor control, and has increasing difficulty climbing stairs and rising from low chairs, though she continues to ambulate independently for short distances at home.
Her speech has become mildly more slurred over the past several months, particularly when fatigued. She occasionally coughs while drinking thin liquids but denies recurrent aspiration pneumonia or significant weight loss. She reports intermittent calf and hand cramps, diffuse fasciculations and morning fatigue. She has mild exertional shortness of breath but denies orthopnea, morning headaches or daytime hypersomnolence. She remains compliant with riluzole and edaravone and continues multidisciplinary ALS clinic visits, speech therapy and physical therapy.
Past Medical History
Current Medications
Past Surgical History
Family History
Social History
Married and lives with her husband, who assists with several household activities. Retired elementary school teacher. Never smoked, drinks alcohol rarely, denies illicit drug use. Remains engaged in outpatient physical therapy and performs daily stretching at home.
Functional Status
Activities of Daily Living (ADLs)
Instrumental Activities of Daily Living (IADLs)
Review of Systems
Vitals
Mental Status Exam
Neurological Exam
Labs & Imaging
Laboratory Tests (June 2026)
CBC and CMP within normal limits. AST 28, ALT 31. Creatinine 0.82 (eGFR 88). Liver function stable on riluzole.
Pulmonary Function Testing (June 2026)
Forced vital capacity 74% predicted, decreased from 81% six months earlier. Maximal inspiratory pressure mildly reduced.
Electromyography (April 2024)
Widespread active and chronic denervation affecting bulbar, cervical, thoracic and lumbosacral segments, consistent with motor neuron disease.
Assessment
Plan
1. Amyotrophic Lateral Sclerosis
Expected gradual progression of limb-onset ALS with increasing upper-extremity weakness, gait impairment and mild bulbar involvement. Combined upper and lower motor neuron findings without sensory abnormalities. Functionally independent for most basic activities but needs increasing assistance with demanding tasks.
2. Bulbar Dysfunction
Increasing dysarthria and intermittent coughing with thin liquids raise concern for progressive bulbar involvement.
3. Respiratory Function
Pulmonary function testing shows a mild decline in forced vital capacity.
4. Mobility and Muscle Spasticity
Progressive weakness and spasticity continue to affect gait and upper-extremity function.
5. Advance Care Planning
The progressive nature of ALS and future care needs were reviewed with the patient and her husband.
Ordered
Procedures
Follow Up
Follow-up in three months through the multidisciplinary ALS clinic to reassess motor function, bulbar symptoms, respiratory and nutritional status and functional independence. Advised to seek prompt evaluation for rapidly worsening weakness, increasing swallowing difficulty, recurrent aspiration, significant weight loss or progressive shortness of breath.
NEW PATIENT
New Patient Consultation
Captures full neurological history, review of systems, exam, and initial assessment and plan.
WHAT MARVIX AI CAPTURES
Captures
Chief complaint, HPI, ROS, full neuro exam
Coding
New-patient E/M level with MDM rationale
Also generates
Diagnostic workup orders and referral letters
HEADACHE
Headache & Migraine Visit
Captures headache days, laterality, aura, triggers, HIT-6 scoring, and preventive response.
WHAT MARVIX AI CAPTURES
Captures
Headache frequency, laterality, aura, triggers, HIT-6 score
Coding
Migraine subtype ICD-10 with severity
Also generates
Preventive therapy plan and AVS
EPILEPSY
Epilepsy Follow-up
Documents seizure semiology, frequency, aura, medication adherence, and anti-seizure drug levels.
WHAT MARVIX AI CAPTURES
Captures
Seizure semiology, frequency, aura, medication adherence
Coding
Epilepsy type ICD-10, intractability status
Also generates
Drug-level orders and dosing plan
MOVEMENT
Movement Disorder Visit
Records UPDRS findings, tremor, rigidity, gait, and medication timing for Parkinson's and related disorders.
WHAT MARVIX AI CAPTURES
Captures
UPDRS findings, tremor, rigidity, gait, medication timing
Coding
Parkinson's/movement disorder ICD-10
Also generates
PT referral and titration plan
MS
Multiple Sclerosis Visit
Logs EDSS scoring, relapse history, disease-modifying therapy, and surveillance imaging plans.
WHAT MARVIX AI CAPTURES
Captures
EDSS score, relapse history, DMT status
Coding
MS ICD-10 with course specifier
Also generates
Surveillance MRI order and therapy summary
COGNITIVE
Cognitive & Dementia Eval
Documents MoCA or MMSE scores, functional status, caregiver input, and staging.
WHAT MARVIX AI CAPTURES
Captures
MoCA/MMSE scores, functional status, caregiver input
Coding
Dementia stage ICD-10
Also generates
Workup orders and caregiver instructions
STROKE
Post-Stroke Follow-up
Records NIHSS, residual deficits, secondary prevention, and rehabilitation referrals.
WHAT MARVIX AI CAPTURES
Captures
NIHSS, residual deficits, secondary-prevention regimen
Coding
Post-stroke ICD-10 with deficit specifiers
Also generates
Rehab referral and BP-control plan
NEUROMUSCULAR
Neuromuscular Visit
Captures strength grading, reflexes, EMG or NCS results, and ALSFRS-R where relevant.
WHAT MARVIX AI CAPTURES
Captures
Strength grading, reflexes, EMG/NCS findings, ALSFRS-R
Coding
Neuromuscular ICD-10 with etiology
Also generates
Lab orders and follow-up plan
TELECONSULT
Teleconsult Visit
Captures the full remote encounter with the same structured note and coding as in person.
WHAT MARVIX AI CAPTURES
Captures
Full remote encounter, symptom review, modality
Coding
Telehealth E/M with modifier
Also generates
Refill orders and AVS
PROCEDURE
In-Office Procedure
Documents botulinum toxin, nerve blocks, and EMG/NCS studies with consent and technique detail.
WHAT MARVIX AI CAPTURES
Captures
Indication, consent, sites, dosing and technique
Coding
Procedure CPT with units and modifiers
Also generates
Post-procedure instructions and AVS
Generic scribes
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Marvix AI
Neurology Documentation
General-purpose templates
Built for 14 neurology subspecialties
Pre-Visit Preparation
Manual chart review / limited support
AI-generated Patient Recaps
Provider-Personalized Notes
Standardized note output
Learns your documentation style
Long, Complex Consults
Limited context handling
Designed for detailed neurological visits
Questionnaires & Scores
Manual documentation / limited support
Medical Billing & Coding
Limited support
ICD-10, CPT & E/M coding with MDM rationale
Team Collaboration
Limited support
Physicians, MAs, NPs & nurses collaborate in one note
AI Assistant
Not available
Chat with every consult using transcripts, notes & uploaded files
EHR Integration
Varies by platform
Deep two-way integration with major EHRs
Payer Compliance
Not addressed
LCD criteria, NCCI/modifier compliance & prior-auth alignment built in
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