What general neurology is

General neurology is the evaluation and treatment of conditions affecting the brain, spinal cord, nerves, and muscles. Most patients seen in this practice are here for exactly this kind of care — a genetic cause is the exception, not the rule, and most neurological concerns are fully addressed without ever needing genetic testing.

Conditions commonly evaluated

  • Headache and migraine
  • Stroke and cerebrovascular disease
  • Epilepsy and seizure disorders
  • Parkinsonism and other movement disorders
  • Dementia and cognitive disorders
  • Peripheral neuropathy
  • Muscle disorders
  • Neuromuscular disease
  • Balance disorders and dizziness
  • Tremor
  • Other neurological symptoms warranting specialist assessment

What to expect during consultation

A visit typically includes a detailed history, a neurological examination, and a discussion of what further testing — if any — is needed. Imaging, electrodiagnostic studies, or laboratory work-up are requested only when they are likely to change the diagnosis or the management plan, not as routine.

When genetic evaluation may become part of the work-up

For most patients, genetic testing is not part of the evaluation. Occasionally, findings from the history or exam — an early age of onset, a family pattern of similar illness, or a presentation that doesn’t fit a typical acquired cause — suggest that a genetic contribution is worth considering. In those situations, this is discussed openly, and a referral into the Neurogenetics Service happens as a natural extension of the same care, not a separate process.

Individualized care, not routine testing

Every recommendation here is made for the individual patient in front of us, based on their history and findings. Genetic testing is a tool used when it is likely to be useful — not a default step, and not something offered simply because it is available.

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Scope of referrals

This service accepts adult neurology referrals across the full range of common and complex presentations, including headache, stroke and cerebrovascular disease, epilepsy, movement disorders, cognitive disorders, peripheral neuropathy, myopathy, and neuromuscular disease.

Areas of clinical interest

Particular clinical interest and experience in neurocritical care (acute stroke, subarachnoid hemorrhage, status epilepticus, Guillain-Barré syndrome, and related acute encephalopathies), and in neuromuscular and neurodegenerative disease more broadly, informed by ongoing research in these areas.

Diagnostic approach

Careful clinical phenotyping precedes investigation. History and examination determine which, if any, work-up is pursued — imaging, electrodiagnostics, laboratory testing, or genetic evaluation are each used selectively, based on pretest probability, rather than ordered as a standard panel.

When a neurogenetics referral may be appropriate

Within the course of general neurological care, referral to the Neurogenetics Service may be considered for:

  • Onset earlier than typical for the phenotype
  • A family history consistent with a heritable pattern
  • Atypical, treatment-refractory, or diagnostically unresolved presentations where a genetic etiology remains plausible
  • Patients or families requesting genetic counseling in the context of a suspected hereditary neurological condition

Genetics is not proposed as a routine step in the general neurology work-up; it is reserved for presentations where it is likely to add diagnostic or management value.

Collaboration and co-management

Co-management with referring physicians is the norm, not the exception. Where a patient’s care is shared, communication is maintained throughout — from initial evaluation through any further testing or follow-up — so that referring physicians remain informed partners in the patient’s care rather than recipients of a final report.

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