NICE publishes guideline on recognising neurological conditions

NICE has published a new guideline (NG127) on the recognition and referral of patients with suspected neurological conditions. The guidance aims to help non-specialist healthcare professionals to identify people who should be offered further specialist investigation.

NICE says that suspected neurological conditions account for about one in 10 GP consultations and a further one in 10 emergency admissions (excluding stroke). Neurological conditions often present with symptoms that are difficult to diagnose. According to a 2015 survey by the Neurological Alliance that included 6916 people with a diagnosed neurological condition, nearly a third (31.5%) of respondents had to see their GP five or more times before being referred to a neurological specialist, and 39.8% had to wait more than a year from when they first noticed their symptoms to seeing a specialist.

The guideline aims to make sure GPs and emergency doctors can recognise when symptoms could have a neurological cause and to know when to refer to a specialist straight away and when to carry out more tests first, as well as how to avoid unnecessary referrals. It includes sections on each of the key signs and symptoms that could indicate the presence of a neurological condition, such as blackouts, dizziness and vertigo, headaches, memory problems, sleep disorders, tics and tremor.

The recommendations for adults and for children aged under 16 years are presented separately, and for each set of symptoms, the guidance lists the possible causes, when to refer immediately (ie within a few hours or even quicker), urgently (ie within two weeks) or routinely. It also suggests further tests that can be conducted within the non-specialist setting.

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