Stone J, Carson A, Duncan R, Roberts R, Warlow C, Hibberd C, Coleman R, Cull R, Murray G, Pelosi A, Cavanagh J, Matthews K, Goldbeck R, Smyth R, Walker J, Sharpe M
School of Molecular and Clinical Medicine, University of Edinburgh, United Kingdom.
Clin Neurol Neurosurg. 2010 Nov;112(9):747-51. doi: 10.1016/j.clineuro.2010.05.011. Epub 2010 Jun 19.
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.
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'.
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.
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.
有关转诊至神经内科门诊所做诊断的性质和相对频率的信息，是服务、教学和研究工作重点的重要指南。此前关于该主题的研究因仅涉及单一中心或缺乏细节而受到限制。我们旨在描述大量转诊至神经内科门诊的病例所做出的神经学诊断。
在15个月的时间里，招募了英国苏格兰所有国民保健服务（NHS）神经中心神经内科门诊新转诊的患者。评估的神经科医生记录他们做出的初步诊断。对于那些仅描述诸如“疲劳”等症状的诊断，使用神经科医生认为患者症状由疾病解释的程度的额外评级进行分类。
3781名患者参与研究（占符合条件者的91%）。做出的最常见诊断类别为：头痛（19%）、功能性和心理性症状（16%）、癫痫（14%）、周围神经疾病（11%）、其他神经疾病（10%）、脱髓鞘疾病（7%）、脊柱疾病（6%）、帕金森病/运动障碍（6%）和晕厥（4%）。并提供了每个类别的详细分类。
头痛、功能性/心理性障碍和癫痫是新转诊至神经科服务的患者中最常见的诊断。该信息应用于确定服务、教学和研究的重点。
