Advice from a Consultant Neurologist
This information is sourced from Dr Michael Zandi, Consultant Neurologist
How should we approach patients reporting neurological symptoms after mild Covid infection and who should we refer to secondary care?
At the moment, I would simply advise GPs to refer patients with neurological presentations that you would normally refer to secondary care. For example, first episode of seizure, progressive or focal neurological signs or loss of function. Until we have clear criteria, I would advise GPs err of the side of referral more whilst we work out the neurological sequelae of Covid
I would also advise clinicians to try and see people face to face. Focal signs are more obvious when you see someone in clinic compared to remote assessment. For example, I have conducted remote consultations with post-viral patients who I’m fairly convinced don’t have any specific concerns. However, it is only when I see them in clinic that I pick up they are ataxic or hemiparetic and hence need further investigation. The same goes the other way, some will present quite normally walking around the room despite reporting significant symptoms
I would recommend GPs conduct a quick 1 minute neurological examination. It is important to see whether a patient can get out of chair with their arms crossed, what their speech is like, what their affect is like. It is important to look for signs of gross weakness