Aim To evaluate the role of a regular neurology review in acute medical receiving. Over 5 weeks, patients admitted to acute medical receiving were reviewed by a neurologist. Presenting complaint, medical diagnosis, and neurological diagnosis were documented. Other neurological illnesses leading to admission were also identified, but not reviewed.
Results 51 patients were reviewed (14 headaches, 37 blackouts). Eight patients with other neurological symptoms were also identified. 31 males were seen, of whom five were headaches (16%). Of the 20 females, nine were headache (45%). A diagnosis was made by the admitting physician in 6 headache patients (43%). The remaining eight headache patients were diagnosed by the visiting neurologist and two of the physicians’ diagnoses were revised. The diagnosis made by the admitting physician in 13 blackout patients was unclear (35%). Diagnosis was made by the visiting neurologist in these patients and diagnoses were revised in nine other patients (24%). Five headache patients were followed up in neurology outpatient. Migraineurs were initiated on appropriate prophylaxis with GP follow. Five first seizures were referred to 1st fit clinic, while the SAH and subdural patients were transferred directly to neurosurgery.
Conclusions These results suggest that a daily neurology review service is useful in medical receiving units by clarifying diagnoses, directing tests, and limiting inappropriate follow-up.
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