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Refer immediately, in line with local pathways, adults who have severe low back pain radiating into the leg and new-onset disturbance of bladder, bowel or sexual function, or new-onset perineal ...
NICE
National Institute for Health and Clinical Excellence (NICE)
The committee agreed that these symptoms can indicate cauda equina syndrome, which is a medical emergency.
ver más ... 2019Refer immediately adults with rapidly (within 4 weeks) progressive symmetrical limb weakness for neurological assessment and assessment of bulbar and respiratory function.
NICE
National Institute for Health and Clinical Excellence (NICE)
The committee agreed that rapidly progressive symmetrical limb weakness can indicate a potentially life-threatening neuromuscular disorder or cervical myelopathy. These disorders can affect the respiratory muscles and cause respiratory failure. Their presenting features can be difficult to recognise in the early stages of the disorder.
ver más ... 2019Refer adults with recurrent fixed-pattern dizziness associated with alteration of consciousness to have an assessment for epilepsy in line with the NICE guideline on epilepsies.
NICE
National Institute for Health and Clinical Excellence (NICE)
The committee noted that epilepsy can sometimes present as recurrent fixed-pattern dizziness associated with alteration of consciousness.
ver más ... 2019For adults with sudden-onset acute vestibular syndrome (vertigo, nausea or vomiting and gait unsteadiness), a HINTS (head-impulse–nystagmus–test-of-skew) test should be performed if a healthcare ...
NICE
National Institute for Health and Clinical Excellence (NICE)
For adults with sudden-onset acute vestibular syndrome who have had a HINTS test: be aware that a negative HINTS test makes a diagnosis of stroke very unlikely refer immediately for neuroimaging if the HINTS test shows indications of stroke (a normal head impulse test, direction-changing nystagmus or skew deviation). Refer immediately adults with sudden-onset acute vestibular syndrome in whom benign paroxysmal positional vertigo or postural hypotension do not account for the presentation, in ...
ver más ... 2019Refer adults who have sudden-onset difficulty with handwriting that has no obvious musculoskeletal cause for a neurological assessment according to local stroke pathways.
NICE
National Institute for Health and Clinical Excellence (NICE)
Ask adults who have difficulty with handwriting that has no obvious musculoskeletal cause to demonstrate their handwriting and: if they have a problem with generating language rather than hand function, refer for neurological assessment if their handwriting is small and slow, consider referring for possible Parkinson's disease if their difficulty is specific to the task of handwriting and examination shows no other abnormalities, consider referring for possible focal dystonia.
ver más ... 2019