Cognitive Neurology Service

What we do

We aim to provide the following:

• Cognitive neurology referral service for patients of the RMH
• Cognitive outcome evaluation for patients with neurological diseases
• Referral centre for the clinical assessment of patients with atypical dementias, including genetic syndromes, rapidly progressive cognitive decline, young onset dementias, patients with predominantly behavioural symptoms, and early onset or atypical Alzheimer’s disease (AD)
• Central referral service for acquired speech and language disorders secondary to neurodegeneration
• A centre of excellence for dementia diagnosis in collaboration with the Cognitive Dementia and Memory Service (CDAMS) and Neuropsychiatry
• Support and expansion of dementia clinical trials network including trials for Alzheimer’s dementia and frontotemporal dementia (FTD)

Who do we see?

We generally see:

• people with atypical cognitive syndromes, especially if they have pre-existing or associated neurological problems, or if they present with early changes to speech, language, or behaviour
• younger patients than normal, with at least half of our patients aged less than 65 years. We tend to refer people aged over 80 and those who are elderly with complex medical conditions to regional CDAMS, as they are more likely to benefit from their multidisciplinary approach. However, we do assess each referral on a case-by-case basis.

We will accept those with speech, language and behavioural features that may benefit from our specialist service. Patients with AD presenting with speech and language problems early in the disease course, and those with more atypical features, will be seen. We see many patients with established neurological disease or cognitive issues following neurosurgery, as well as patients where the syndromic diagnosis is unclear and would benefit from cognitive review.

We also offer a cognitive outcomes service for people with brain injury, including injuries after experiencing autoimmune encephalitis, stroke and brain tumours.

Who can use our service

This clinic is suitable for:

• Adults (aged 18 years or over)
• Patients with suspected progressive cognitive decline
• Patients who have had cognitive or behavioural change
• Patients who may have associated neurological symptoms or signs

This clinic is not suitable for:

• Paediatric patients
• Patients for follow up or congenital or developmental problems such as intellectual disability, Attention Deficit Hyperactivity Disorder (ADHD), learning deficits and autism, unless there is a clear new component.
• Patients with a primary psychiatric diagnosis, or patients with prominent psychotic features (these patients are best evaluated by our Neuropsychiatry service)
• Elderly patients with extensive comorbidities (these patients are best managed via their regional CDAMS clinics)