RT Journal Article
SR Electronic
T1 Experience from two decades of the Cambridge Rapid Access Neurology Clinic
JF Clinical Medicine
JO Clin Med
FD Royal College of Physicians
SP 437
OP 441
DO 10.7861/clinmedicine.15-5-437
VO 15
IS 5
A1 Laura T Axinte
A1 Barnaby D Fiddes
A1 Alastair Donaghy
A1 Adam Whyte
A1 Chris Allen
A1 Stephen J Sawcer
A1 Robert J Adam
A1 Sybil RL Stacpoole
YR 2015
UL http://www.rcpjournals.org/content/15/5/437.abstract
AB We report on the evolution of the rapid access neurology clinic (established in 1995) at Addenbrooke's Hospital, Cambridge. Annualised attendance data demonstrate an ever increasing demand, with primary headache disorders now accounting for more than 40% of referrals. Secondary causes of headache (including intracranial tumours, idiopathic intracranial hypertension, carotid or vertebral artery dissection and subdural haematomas) remain infrequent. In all such cases, there were additional diagnostic clues. The number of patients referred with problems related to chronic neurological diseases has fallen considerably, reflecting the roles of specialist nurses and clinics. Imaging investigation of choice shifted from computerised tomography scan (45 to 16%) towards magnetic resonance imaging (17 to 47%). Management is increasingly on an outpatient basis, often without the need for a follow-up appointment. The experience presented here should inform further development of rapid access neurology clinics across the UK and suggests the need for acute headache services, in line with those for transient ischaemic attack and first seizure.