What we deal with in Neurology

Neurologists at University Hospitals Birmingham NHS Foundation Trust (UHB) are all specialists in one or more branches of neurology. Where possible a patient will be directed to a specialist clinic.

Patients with symptoms that could be caused by a number of different subspecialties may need to be evaluated in a general neurology clinic first.

Headache

Subspecialty	Notes
Complex headache	Suspected raised intracranial pressure, meningitis or subarachnoid hemorrhage should go to the Emergency Department First line diagnosis and management of migraine should be in primary care Suspected or proven brain tumours are dealt with via a dedicated pathway, not Neurology

Blackouts or funny turns

Subspecialty	Notes
First seizure Epilepsy	Syncope (fainting) is managed by cardiology in most cases Wherever possible, patients have a witness of one or more attacks present with them or available on the phone, this is often how the diagnosis is made

Tremors or abnormal movements

Subspecialty	Notes
Movement disorders Botox clinic	Please refer to the Geriatric Team if: Aged over 75 Aged 75 or under with: Frailty marker (e.g. falls, immobility, delirium or incontinence) Cognitive presentation Dependence on carer support or a care home resident

Subspecialty

Notes

Movement disorders
Botox clinic

Please refer to the Geriatric Team if:

Aged over 75
Aged 75 or under with:
- Frailty marker (e.g. falls, immobility, delirium or incontinence)
- Cognitive presentation
- Dependence on carer support or a care home resident

Weakness and/or numbness and/or tingling

Subspecialty	Notes
Multiple sclerosis Neuroinflammation and myasthenia gravis Peripheral neuropathy (inflammatory and hereditary) Motor neurone disease Muscle disease	Suspected stroke or transient ischaemic attack (TIA, mini stroke) is not dealt with by Neurology It is very rare to have MS with a normal brain scan, where there is no abnormality on clinical examination, a brain scan may be a better option than a Neurology appointment You cannot refer directly to the majority of these clinics from primary care, in most cases investigations and assessment in general Neurology clinic will be needed prior to referral

Subspecialty

Notes

Multiple sclerosis
Neuroinflammation and myasthenia gravis
Peripheral neuropathy (inflammatory and hereditary)
Motor neurone disease
Muscle disease

Suspected stroke or transient ischaemic attack (TIA, mini stroke) is not dealt with by Neurology
It is very rare to have MS with a normal brain scan, where there is no abnormality on clinical examination, a brain scan may be a better option than a Neurology appointment
You cannot refer directly to the majority of these clinics from primary care, in most cases investigations and assessment in general Neurology clinic will be needed prior to referral

Neurorehabilitation issues

Subspecialty	Notes
Complex neurorehab	In the majority of cases neurorehabilitation can be provided by community teams or by Moseley Hall Hospital or the West Midlands Rehabilitation Centre

Head injury

Subspecialty	Notes
Brain injury clinic	Acute severe head injury should go to the Emergency Department 70% or patients with concussion or mild traumatic brain injury (mTBI) will recover within three months without specialist intervention Patients with historic brain injuries and complex rehab needs may need complex neuro-rehab rather than the head injury clinic Patients requiring reconstructive surgery need to be referred to neurosurgery

Subspecialty

Notes

Brain injury clinic

Acute severe head injury should go to the Emergency Department
70% or patients with concussion or mild traumatic brain injury (mTBI) will recover within three months without specialist intervention
Patients with historic brain injuries and complex rehab needs may need complex neuro-rehab rather than the head injury clinic
Patients requiring reconstructive surgery need to be referred to neurosurgery

Last reviewed: 04 December 2024