FRONT DOOR NEUROLOGY: THE GP EXPERIENCE

IntroductionNeurological symptoms are common in primary care and may represent 10% of consultations. With fewer neurologists in the UK compared to other European nations, the RCGP encourages GP engagement with neurological disease. This project sought to delineate neurological presentations to a large Brighton GP practice.MethodDuring a four-month GP placement, an FY2 doctor recorded details of patients presenting with neurological symptoms. In tandem, six months of neurology referrals by the permanent GPs were analysed.ResultsCommon symptoms among 29 FY2 neurologically-oriented appointments included headache (n=8), paraesthesiae (n=4) and funny turns (n=3). Significant new diagnoses included right LACS, post-concussion syndrome and cervical radiculopathy. Most (65%) of patients were managed in GP. Those referred included two to TIA clinic, one to A&E and one to headache service. Of 12 GP referrals reviewed, no neurological examination was documented in 25%, and six provisional diagnoses were in agreement with neurological opinion. After neurology outpatient review, two patients were assessed as having no neurological problem.ConclusionsHeadache forms a large component of primary care neurology, but a variety of cases is seen. Acute presentations may be referred to TIA clinic or A&E. Where stated, GP opinion was frequently in line with neurology review.