Introduction Neurologists in medical admissions units (MAU) and in acute liaison jobs are now fairly common practice in many District General Hospitals (DGH. First seizure clinics, multiple sclerosis relapse (MS) and acute or hot clinics are aimed at decreasing hospital admissions and MAU attendances of patients with neurological problems. Some however slip through the net. This retrospective case series highlights the patients with either established or new neuro-inflammatory disease who attended MAU and a hot clinic over a 12 month period in a busy DGH.

Method Neuro-inflammatory cases were ascertained in the MAU and in an acute clinic in a large DGH by a neurology registrar over a 12 month period.

Results Overall 19 patients were seen (16 in MAU and 3 in an acute or ‘hot clinic’). In the MAU 31% (5) were a new diagnosis of MS, 25% (4) were admitted with an infection and acute MS worsening, (2) were in relapse, 12.5% (2) had progressive disease, 12.5% (2) were admitted due to allied symptoms, and one patient was a social admission. In the acute clinic two patients were new diagnoses of MS and one patient had a previous diagnosis of ADEM. Some cases will be illustrated.

Conclusion This case series illustrates that despite novel clinics aimed at decreasing admission to hospital of patients with neurological disease, new diagnoses are still made in MAU, in a timely manner and neurologists must be able to work alongside acute physicians and identify and treat those with infection or in relapse and be able to manage those with disease progression.