Suspected Neurological Conditions: Recognition and Referral
National Institute for Health and Care Excellence. (2019).
London (United Kingdom): National Institute for Health and Care Excellence, 1-170.
This guideline provides recommendations for the recognition and referral of adults and children with suspected neurological conditions.
National Guideline Centre (United Kingdom); National Institute for Health and Care Excellence (United Kingdom)
This guideline was reviewed with the following:<ul><li>National Institute for Health and Care Excellence. (2021). Suspected Neurological Conditions: Recognition and Referral (Quality Standard 198). Retrieved from <a href="https://www.nice.org.uk/guidance/qs198">www.nice.org.uk</a></li></ul>
<div>Children with progressive limb weakness or motor developmental delay without risk factors for cerebral palsy should be referred to allied health professionals, such as speech-language pathologists, based on specific developmental needs.</div>
<div>For adults with isolated and unexplained persistent dysphonia, consider referring for an assessment for laryngeal dystonia if hoarseness due to structural abnormality or malignancy was already excluded. Persistent dysphonia may be a presenting symptom of a neurological condition, such as Parkinson's disease.</div>
<div>Adults with a sudden onset of speech or language disturbances should be immediately referred to be assessed for a vascular event.</div>
<div>For children two years and older, referral to speech and language services should be considered if they demonstrate abnormal speech development. Clinicians should be aware that delay or regression in speech and language in children can be a symptom of autism and should refer to the NICE guideline on the recognition, referral, and diagnosis of autism spectrum disorder.</div>
<div>Adults with progressive slurred, disrupted speech, and/or evidence of swallowing impairment should be referred for an assessment for motor neuron disorders.</div>
<div>Children with a new onset of slurred or disrupted speech should be referred for a neurological assessment. Stuttering or stammering in children may be an unlikely symptom of underlying progressive neurological disorder and referral to speech therapy would only be needed if it significantly impacts the child’s ability to communicate.</div>
