Chapman F A, Pope A E, Sorensen D, Knight R S, Al-Shahi Salman R
Bramwell Dott Building, Division of Clinical Neurosciences, Western General Hospital, Crewe Road South, Edinburgh EH4 2XU, UK.
J R Coll Physicians Edinb. 2009 Dec;39(4):296-300. doi: 10.4997/JRCPE.2009.402.
In secondary care, some patients with acute neurological symptoms are never seen by a neurologist. Rapid access neurology clinics could provide patients with timely access to neurology services. We analysed a retrospective cohort of 12,024 consecutive patients attending the 'immediate care' area of the emergency department or the acute medical admissions unit of the Royal Infirmary of Edinburgh. A total of 1,036 patients (9%) presented with a neurological complaint, of whom 680 (66%) did not have any contact with neurology services. The most common problems were epileptic seizure, cerebrovascular diseases and headache. Of the patients with epileptic seizure or headache who were not seen by a neurologist, about 40% might have benefited from neurological assessment. Following the introduction of a weekly rapid access neurology clinic, the most common problems seen were headache, symptoms that turned out to be medically unexplained and epileptic seizure.
在二级医疗保健中，一些有急性神经症状的患者从未见过神经科医生。快速就诊神经科诊所可为患者提供及时的神经科服务。我们分析了一个回顾性队列，该队列由连续12024名在爱丁堡皇家医院急诊科的“即时护理”区域或急性内科住院部就诊的患者组成。共有1036名患者（9%）出现神经方面的主诉，其中680名（66%）未与神经科服务有任何接触。最常见的问题是癫痫发作、脑血管疾病和头痛。在未见过神经科医生的癫痫发作或头痛患者中，约40%可能会从神经科评估中受益。引入每周一次的快速就诊神经科诊所以后，所见到的最常见问题是头痛、最终被证明医学上无法解释的症状和癫痫发作。
