title: [Aetiological analysis of 425 patients referred to an outpatient neurology service due to tremor or Parkinsonism].
abstract: BACKGROUND
  Movement disorders are a common reason for visits to outpatient neurology departments. This study has two objectives. The first is to analyse the diagnoses of patients referred to the neurology service due to tremor or Parkinsonism. The second aim is to analyse whether such patients are referred from primary care correctly or incorrectly.
  
  
  METHODS
  The study examines patients referred from primary care to the neurology service in a medical specialty centre because of tremor or Parkinsonism. The final diagnoses established by the neurologist were analysed and patient referral was also analysed using a set of previously agreed criteria.
  
  
  RESULTS
  The sample consisted of 425 consecutive patients who were referred from primary care due to tremor (n = 294) or Parkinsonism (n = 131). The most common diagnoses were Parkinson's disease (n = 211; 50%), essential tremor (n = 157; 37%) and pharmacological Parkinsonism (n = 23; 5%). Referral was considered to be incorrect in 39 patients and correct in 388 cases (91%). The causes of incorrect referrals were: pharmacological Parkinsonism (n = 23), anxiety that was not treated in primary care (n = 12) and hypothyroidism that went undiagnosed in primary care (n = 4).
  
  
  CONCLUSIONS
  Parkinson's disease, essential tremor and pharmacological Parkinsonism are the most frequent diagnoses in patients who are referred from primary care because of tremor and Parkinsonism. Referral to a neurology service is correct in most cases, but there is still room for improvement.
authors.affiliation: Servicio de Neurología, Hospital Vega Baja, Orihuela, Alicante, España. aperezs@mac.com
authors.forename: Angel Pérez
authors.initials: AP
authors.lastname: Sempere
authors.forename: Vicente
authors.initials: V
authors.lastname: Medrano
authors.forename: José Luis
authors.initials: JL
authors.lastname: Pardo-Franco
authors.forename: Juan Manuel
authors.initials: JM
authors.lastname: Callejo-Dominguez
authors.forename: Eloísa
authors.initials: E
authors.lastname: Delsors Merida-Nicolich
authors.forename: Santiago
authors.initials: S
authors.lastname: Mola
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000554:Ambulatory Care Facilities; D003951:Diagnostic Errors; D006801:Humans; D008297:Male; D008875:Middle Aged; D009462:Neurology; D020734:Parkinsonian Disorders / Q000175:diagnosis* / Q000503:physiopathology; D011320:Primary Health Care; D012017:Referral and Consultation; D014202:Tremor / Q000175:diagnosis* / Q000209:etiology*; D055815:Young Adult