Suspected stroke or transient ischaemic attack (mini stroke)
This is managed by the Stroke Team which is a dedicated group of doctors specialising in stroke medicine, some are neurologists.
Uncomplicated or isolated headache
Detailed advice on the management of migraine can be found on the migraine page.
Syncope (fainting)
A single episode of triggered syncope doesn’t need to be referred as long as the patient has a normal ECG.
Recurrent syncope needs to be referred to cardiology for advice on suitable investigation and management – often simple measures can be used to prevent low blood pressure.
Suspected or proven brain tumour
The current pathway for managing suspected or proven brain tumours can be found on the MRI referrals page:
If the patient is known to the neuro-oncology team at UHB, the best way to seek advice is via the CNS team.
Back or neck pain
All spinal problems and imaging (both routine and urgent) should be directed to the community spinal triage team in the first instance. As part of this, if we were to consider as neurologists that spinal imaging were to be appropriate, the next step would still be for the GP to refer to the community spinal triage team.
Referrals to the community spinal triage team can be made via eRS (BCHC MSK service/Spinal Assessment service) or by emailing a referral letter.
Unilateral deafness or tinnitus (or acoustic neuroma)
Patient should be referred to local Ear, Nose and Throat (ENT) services for audiology +/- imaging and assessment.
Where a scan has shown an acoustic neuroma (a benign tumour on the nerve to the ear) the patient should be referred to the neuro-oncology CNS team.
Vertigo
Patients should be referred to local ENT services.
Suspected pituitary problems
If the patient is complaining of visual disturbance they should be referred for urgent ophthalmology opinion.
If the patient has no visual problems they should be referred to local endocrine (hormone doctor) services.
Isolated visual disturbance, double vision +/- pain in or around the eye
Patient should be referred to local ophthalmology services.
Carpal tunnel syndrome and other single nerve lesions (e.g. ulnar nerve, meralgia paresthetica)
If you suspect carpal tunnel syndrome (CTS) please refer the patient for neurophysiology. You can write to the department at Queen Elizabeth Hospital Birmingham or City Hospital Birmingham.
Confirmed carpal tunnel syndrome is treated by hand surgery consultants at University Hospitals Birmingham NHS Foundation Trust and is also the Hand Surgery department at the Royal Orthopaedic Hospital.
Memory problems
If the patient is rapidly getting worse they can be referred for a scan as a suspected brain tumour – it is important that details of memory tests are included.
If the patient is gradually getting worse they should be referred local memory services. For Birmingham and Solihull this is done via a single point of access.
Last reviewed: 18 March 2024
