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The economic impact of neurological illness on the health and wealth of the nation and of individuals
  1. Richard Langton Hewer
  1. Department of Social Medicine, University of Bristol, Canynge Hall, Whiteladies Road, Bristol BS8 2PR, UK

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    This chapter attempts to cover not only the financial, but also the human, cost of neurological disorders. A neurological disorder is one that affects the nervous system. It is not simply a disorder that is the “prerogative” of neurologists. The term embraces neurosurgical conditions and also the multitude of neurological conditions encountered by general practitioners and by general medical and orthopaedic specialists. By convention, primarily psychiatric disorders are excluded, as are those that cause learning difficulties from birth (unless there is a clear cut structural cause). However, such a division is becoming rapidly less logical as more and more structural and biochemical abnormalities emerge.

    Epidemiological aspects

    Neurological disorders have certain notable characteristics:

    • They are large in number

    • Few neurological disorders are totally curable, although new, and expensive, treatments are currently being introduced for many of the major neurological disorders including multiple sclerosis, motor neuron disease, stroke, epilepsy, and Alzheimer’s disease

    • Neurological disorders are associated with many symptoms

    • Neurological disorders are a major cause of disability and account for a high proportion of severely disabled people under the age of 65.

    • The adverse effects of most neurological diseases can be reduced.

    Three arbitrary groups of neurological disorders can be identified according to their frequency in the general population. Neurological disease, looked at as a group, may be likened to an animal having a small head, a rather large body, and a very long tail. There are a few common diseases, a greater number of less common disorders, and a huge number of uncommon disorders comprising hundreds of separately identifiable conditions. The total cost of the many uncommon diseases taken together is considerable and may well approach that of the common diseases.

    Neurological disorders characterised by full recovery

    There are a few disorders that are followed by full recovery (for example, carpal tunnel syndrome and some forms of meningitis). Some …

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