Acute neurological problems: frequency, consultation patterns and the uses of a rapid access neurology clinic

In secondary care, some patients with acute neurological symptoms are never seen by a neurologist. Rapid access neurology clinics could provide patients with timely access to neurology services. We analysed a retrospective cohort of 12,024 consecutive patients attending the ‘immediate care’ area of the emergency department  or  the  acute  medical  admissions  unit  of  the  Royal  Infirmary  of Edinburgh. A total of 1,036 patients (9%) presented with a neurological complaint, of whom 680 (66%) did not have any contact with neurology services. The most common problems were epileptic seizure, cerebrovascular diseases and headache. Of  the  patients  with  epileptic  seizure  or  headache  who  were  not  seen  by  a neurologist,  about  40%  might  have  benefited  from  neurological  assessment. Following  the  introduction  of  a  weekly  rapid  access  neurology  clinic,  the  most common problems seen were headache, symptoms that turned out to be medically unexplained and epileptic seizure.