Neurology Consult 🧠
Guide for neurology consultation and referral. Key information to provide, common indications, and referral scripts for NCHDs.
📋 Key Info to Have Ready
- Patient identifiers: full name, date of birth, location and MRN; admission may not be for a neurological reason
- Reason for neurology consult: include timing, evolution of symptoms, focal deficits, seizures, altered mental status
- Past Medical History: previous stroke/TIA, epilepsy, migraine, neurodegenerative disorders, vascular risk factors
- Medications: antiepileptics, anticoagulants, antiplatelets
- Observations: GCS, vitals, any evidence of fever or raised ICP
- Neuro exam: clear documentation of focal signs, cranial nerves, limb power, coordination, reflexes
- Imaging: CT brain (if done), MRI if available
- Bloods: FBC, U&E, glucose, CRP, coagulation profile, AED levels if applicable
🔎 Investigations to Know
- CT Brain (non-contrast) – if seizure, stroke, new neuro signs
- Bloods – especially glucose, electrolytes, inflammatory markers
- EEG – if seizures or post-ictal confusion
- MRI Brain – more sensitive for many pathologies; may not be immediate
- Lumbar puncture – if ?meningitis/encephalitis, after imaging clearance
📞 Example Script
- Hi, this is [Your Name], the intern from the [Team Name]. I'm calling to request a neurology consult for a [Age] year-old [M/F] patient, admitted for [reason for admission], but with a neurological concern of [e.g. new seizure, left-sided weakness, confusion].
- They have a background of [e.g. epilepsy, prior stroke, hypertension]. They developed [symptom] at [time], and have had [duration/episodes]. CT brain shows [finding], and neuro exam reveals [focal signs].
- We’d appreciate your input on further investigation or management. Let us know if you’d like any additional workup before review.
📝 Tips
- Document onset and progression of symptoms clearly
- Check drug levels for AEDs if relevant
- Include witness description of seizures if available
- Clarify whether you’re querying stroke, seizure, infection, or other cause