What to Expect
Your consultation will be booked for a specific time. I try my best to keep to time but inevitably some cases take longer than anticipated and so your appointment may be delayed. Even so, rest assured that your consultation will not be curtailed by any delays.
Exploring the problem
The consultation will begin with my reading any referral letters or other documents that pertain to your case. I will then ask questions about your symptoms that allow me to build up a picture of what might be wrong. I will also ask questions about your previous or current medical problems, any surgery you may have had, and what medications you may be taking. I will check if you have any allergies to drugs. You may wish to list this information in advance of the consultation.
In most cases I will then perform a neurological cexamination. This may start by examining your gait, and balance. There will be an examination of the eyes and face that checks for any raised brain pressure and any abnormality of the cranial nerves that go from the brain to the eyes, face mouth, jaw and neck. I will also examine the strength and coordination of the arms and legs, check your arm and leg reflexes and test the sensation in the limbs also. For this examination I will usually need bare arms and legs only and this may be possible with whatever clothing you are wearing. If not then a gown and sheet will be provided. Please do also feel free to request a chaperone.
After the examination we can then discuss my insights into your problem(s). This is the most important part of the consultation. I will explain your situation as I see it and I aim to do so in simple and plain language.
In some cases a final diagnosis can be made at this stage and its management can be discussed. We can also discuss whether any investigations are needed to confirm the diagnosis or to reassure you that more sinister explanations are not involved.
In some cases a final diagnosis is not possible with one consultation and one or more investigations may be needed to clarify matters. Even so it may be possible to rule out some of your concerns so please do let me know if you have any particular diagnoses in mind.
By the end of the consultation you should know the plan for manging your case be that reassurance only, medication or investigations. We will discuss whether any follow up appointment is required and if so when this should take place.