Neurological presentations make up over 4% of presentations in Australian general practice.1 General practitioners (GPs) play a key role in recognising, assessing and treating neurological conditions, including sleep disorders. They also play an important role in preventing possible neurological complications (eg stroke and neuropathies) while managing chronic diseases.
Headache accounts for 1.7% of GP encounters, making it the most common neurological presentation.1 There are multiple causes of headache and GPs need to differentiate between a simple tension-type headache and more severe red flag conditions, of which headache may be a symptom.2
Neurological emergencies, including status epilepticus, subarachnoid haemorrhage and acute stroke are time dependent, and immediate recognition, treatment and escalation to a suitable level of care are essential for the best patient outcomes.3 Meningitis has many different aetiologies, and many cases present to their GP during the course of the illness. The ability to diagnose and initiate treatment is an essential aspect of general practice to improve outcomes.4,5
Dementia accounts for approximately 1.6% of GP encounters,6 and is the second leading cause of death in people aged 75 years and older.7 With the ageing population, new prevalence estimates for dementia reveal that 3.4% of patients aged 65 years or older had a new record of dementia,6 making this an important condition for GPs to consider. Early detection of dementia and other neurological conditions improves outcomes. This includes, for example, the early diagnosis of Parkinson’s disease, multiple sclerosis and Huntington’s disease.
Neurological conditions also affect the young, with brain cancers being the third leading cause of death in those aged one to 14 years.7 Febrile convulsions also commonly occur in children, with approximately one in 20 children experiencing one or more. This can be a source of great distress for parents. Reassurance and education of the parents is the mainstay of management and is a common aspect of day-to-day general practice.8
Epilepsy can develop at any stage of life, but more commonly presents in childhood and adolescence, with a second peak in adults over the age of 60. Approximately 14,600 people are diagnosed with epilepsy each year. Of those with epilepsy, approximately 70% gain control of their seizures with medication.9 The psychological and social impacts are immense, including impacts on education, employment and lifestyle.9-10 GPs therefore play an important role in the diagnosis and ongoing management and monitoring of people with epilepsy.
GPs are also integral to the prevention of neurological complications of chronic diseases such as hypertension and diabetes. More than one hundred stroke events occur every day, making it the third highest cause of disease burden in adults aged 85 years and over.7 GPs are well placed to promote lifestyle changes and disease management in patients at risk of these types of neurological complications.