Neurologists at University Hospitals Birmingham NHS Foundation Trust (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.
Headache
Subspecialty
Notes
Complex headache
Suspected raised intracranial pressure, meningitis or subarachnoid hemorrhage should go to the Emergency Department
First line diagnosis and management of migraine should be in primary care
Suspected or proven brain tumours are dealt with via a dedicated pathway, not Neurology
Blackouts or funny turns
Subspecialty
Notes
First seizure
Epilepsy
Syncope (fainting) is managed by cardiology in most cases
Wherever possible, patients have a witness of one or more attacks present with them or available on the phone, this is often how the diagnosis is made
Tremors or abnormal movements
Subspecialty
Notes
Movement disorders
Botox clinic
Please refer to the Geriatric Team if:
Aged over 75
Aged 75 or under with:
Frailty marker (e.g. falls, immobility, delirium or incontinence)
Cognitive presentation
Dependence on carer support or a care home resident
Weakness and/or numbness and/or tingling
Subspecialty
Notes
Multiple sclerosis
Neuroinflammation and myasthenia gravis
Peripheral neuropathy (inflammatory and hereditary)
Motor neurone disease
Muscle disease
Suspected stroke or transient ischaemic attack (TIA, mini stroke) is not dealt with by Neurology
It is very rare to have MS with a normal brain scan, where there is no abnormality on clinical examination, a brain scan may be a better option than a Neurology appointment
You cannot refer directly to the majority of these clinics from primary care, in most cases investigations and assessment in general Neurology clinic will be needed prior to referral
Neurorehabilitation issues
Subspecialty
Notes
Complex neurorehab
In the majority of cases neurorehabilitation can be provided by community teams or by Moseley Hall Hospital or the West Midlands Rehabilitation Centre
Head injury
Subspecialty
Notes
Brain injury clinic
Acute severe head injury should go to the Emergency Department
70% or patients with concussion or mild traumatic brain injury (mTBI) will recover within three months without specialist intervention
Patients with historic brain injuries and complex rehab needs may need complex neuro-rehab rather than the head injury clinic
Patients requiring reconstructive surgery need to be referred to neurosurgery