Some principles of clinical reasoning apply and determining the nature of the problem in terms of time frame and description to allow localisation and understanding of possible pathologies will help. Even if the nature of the problem feels rare or unusual a clear description will help triage and advice.
Detailed history
GPs or primary care clinicians should ask patients the following and include this in any correspondence:
- Duration of symptoms
- Variability of symptoms
- Progression
- Precise nature of problem to allow localisation (unilateral or bilateral, which parts of the body affected etc.)
- Clinical examination findings
- Specific diagnoses that you are particularly concerned about
- Has the patient already been seen by a neurologist? If so; who, where and when?
- Has the patient had a scan? If so; where and when?
Examination findings
It is impossible to make a reasoned decision regarding how quickly a patient needs to be seen without clinical examination findings.
In most cases, patients who have been referred without having been examined by the referring clinician will be declined.
Does the patient need to see a neurologist?
Not all apparent neurological symptoms are managed by neurologists in the West Midlands. The following pages outline what we do and do not deal with in Neurology:
Continuity of care
Neurological conditions can be rare or difficult to diagnose and tend to be chronic (long term conditions).
If a patient is already under the care of a neurologist or has been seen by a neurologist for the same condition or symptom in the previous two years, please ask the neurologist or team for further advice first.
If a patients neurologist or team cannot continue their care, please include details of who the patient saw and the reason that they cannot continue to provide their care.
Subspecialties
Neurologists at UHB are all specialists in one or more branches of neurology. Where possible a patient will be directed to a specialist clinic.
Patients with symptoms that could be caused by a number of different subspecialties may need to be evaluated in a general neurology clinic first.
Seen elsewhere
If a patient has been seen elsewhere, including other specialities, please include:
- prior correspondence
- results (dates and actual results)
- reasons for a referral to a new centre
Last reviewed: 30 March 2023
