Who is referred to neurology clinics?--the diagnoses made in 3781 new patients.
OBJECTIVE
Information on the nature and relative frequency of diagnoses made in referrals to neurology outpatient clinics is an important guide to priorities in services, teaching and research. Previous studies of this topic have been limited by being of only single centres or lacking in detail. We aimed to describe the neurological diagnoses made in a large series of referrals to neurology outpatient clinics.


METHODS
Newly referred outpatients attending neurology clinics in all the NHS neurological centres in Scotland, UK were recruited over a period of 15 months. The assessing neurologists recorded the initial diagnosis they made. An additional rating of the degree to which the neurologist considered the patient's symptoms to be explained by disease was used to categorise those diagnoses that simply described a symptom such as 'fatigue'.


RESULTS
Three thousand seven hundred and eighty-one patients participated (91% of those eligible). The commonest categories of diagnosis made were: headache (19%), functional and psychological symptoms (16%), epilepsy (14%), peripheral nerve disorders (11%), miscellaneous neurological disorders (10%), demyelination (7%), spinal disorders (6%), Parkinson's disease/movement disorders (6%), and syncope (4%). Detailed breakdowns of each category are provided.


CONCLUSIONS
Headache, functional/psychological disorders and epilepsy are the most common diagnoses in new patient referral to neurological services. This information should be used to shape priorities for services, teaching and research.
Stone
J
J
School of Molecular and Clinical Medicine, University of Edinburgh, United Kingdom. Jon.Stone@ed.ac.uk
Carson
A
A
Duncan
R
R
Roberts
R
R
Warlow
C
C
Hibberd
C
C
Coleman
R
R
Cull
R
R
Murray
G
G
Pelosi
A
A
Cavanagh
J
J
Matthews
K
K
Goldbeck
R
R
Smyth
R
R
Walker
J
J
Sharpe
M
M
D000328:Adult; D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D004827:Epilepsy / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D005260:Female; D005843:Geography; D020773:Headache Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D008875:Middle Aged; D009422:Nervous System Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D009460:Neurologic Examination; D009462:Neurology; D018579:Patient Selection; D011446:Prospective Studies; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012606:Scotland / Q000453:epidemiology; D012737:Sex Factors; D013222:State Medicine / Q000706:statistics & numerical data