Evaluation of referrals from general practice to a neurological department

BACKGROUND: The presence of neurological deficits as obtained from clinical examination increases the likelihood of detecting serious underlying brain disorders. OBJECTIVES: In this study, we assessed the frequency of reported clinical neurological examination in patients referred to neurology. METHODS: We consecutively evaluated referrals to a neurological centre during a 6-month period. RESULTS: From a total of 716 patients, 377 (51%) had an examination reported in the referral letter. Clinical examinations were reported more often in patients with musculo-skeletal disorders compared with others, P = 0.0001. Examination was less likely to be reported in those with a history of disturbed consciousness. CONCLUSION: By showing that only about half of the patients had an examination reported, the study demonstrates that the process of selecting those with a high priority for a secondary neurological service can be improved.