Tired of waiting two years for your general neurology referral to be seen? Good news! Kingston Health Sciences Centre's (KHSC) Division of Neurology and SEAMO are pleased to announce the start of the Neurology eConsult Program. Instead of waiting two or more years for your patient to be seen in a general neurology clinic, the vast majority of your neurology inquiries (we estimate at least 75%) can be initially met with an eConsult response within two to three days. In fact, many of these patients can be managed through eConsult alone and we would encourage you to send all neurology referrals to us initially by eConsult. If the patient needs to be seen in person, we can decide on that once we review the request.
A number of issues can be handled initially with eConsult including:
1. Parkinson’s Disease: How do I start treating PD? By attaching a video of your patient's symptoms, such as a rest tremor, or gait, the neurologist can often help you make the diagnosis quickly. The new Parkinson's Disease Primary Care Pathway can also help you make the diagnosis and initiate a treatment plan.
2. Headache: The vast majority of headache referrals we receive can be handled via eConsult, through which we can advise you on the need for any additional investigations or interventions such as imaging or lumbar puncture, or on the need for in-person follow up with a neurologist. In addition, we can advise on management for more common conditions such as migraine, trigeminal autonomic cephalalgias, other primary headache diagnoses, and secondary causes of headache.
3. Dizziness: Most of the time dizziness is not neurological in origin and we can usually establish that given a detailed history, especially if any brain imaging you have already done does not reveal a cause. Rather than having your patient wait for two years with dizziness-related complaints, you can get a neurological opinion within a few days and either have the patient started on the right treatment and investigations or reassure them that their symptoms are not due to a neurological disorder.
4. Seizures: The diagnosis in this case is based almost entirely on the clinical history, as the neurological examination is usually normal. Through eConsult, the neurologist can advise on alternative diagnoses which often mimic seizure. Additional investigations can also be suggested as needed.
5. Undifferentiated tremor: A patient video with their hands/legs at rest, with their arms in an outstretched position, and performing “finger to nose” testing would improve the value of such an eConsult.
6. Essential tremor.
All KHSC neurologists welcome the opportunity to review your eConsult requests and are committed to providing expert advice for your patients within a few days. See a list of profiles here.