Alcohol burden: Alcohol-related problems are the commonest reason for referral to a specialist neurology service at a major Dublin teaching hospital, newly published research has shown.
Some one in five referrals of people aged between 40 and 60 years is for an alcohol-related problem such as a seizure, the study of almost 600 patients found.
Dr Tim Lynch, Dr Daniel Costello and colleagues at Dublin's Mater Hospital analysed all 575 "in-house" referrals made to the neurology service during 2002. These referrals were made by other consultants in the hospital seeking the assistance of a specialist in the diagnosis and management of patients admitted through the accident and emergency department.
In line with international experience, the reason for most referrals was because the patient had experienced an acute seizure. The cause of the seizure in the majority of cases was due to a person "withdrawing" from alcohol. Most seizures of this nature occur 24-48 hours after an episode of binge drinking.
Writing in the current issue of the Irish Medical Journal, Dr Lynch labels the alcohol-seizure link as "one of the most significant findings of the study".
"This audit emphasises the healthcare burden of alcohol abuse where primary alcohol-related neurological disorders account for 20 per cent of referrals from the 40-60 year age group, many of which were re-offenders," the authors state.
Speaking to The Irish Times yesterday, Dr Lynch said the number of internal referrals to the Mater's neurology service had now increased to almost 900 patients a year, but that the burden of alcohol-related problems had not diminished.
The research found that alcohol-related head injury accounted for 5 per cent of requests for specialist help. Other neurological problems associated with chronic alcohol abuse such as nerve and brain damage were also common. Almost one in 10 patients found to have an alcohol-related disorder had experienced a stroke.
"Not only is alcohol a common preventable cause for neurological hospitalisation, the absolute number of admissions is likely to underestimate the workload generated by alcohol," the authors note.
Overall, the study found that vascular events, such as stroke or transient ischemic attack, were the most common diagnosis in patients over 50. Younger patients were more likely to experience either a seizure or an alcohol-related neurological problem.
Dr Lynch described the in-hospital referral of patients from one speciality to another as "hidden" work within the health system. Criticising both the Health Service Executive (HSE) and the Department of Health, he said it was time that data such as the Mater hospital audit was collected by the health service.
"In-house consultations constitute a significant workload for the neurology service. The lack of awareness of this critical work by the HSE and the department must be addressed."
A 2003 report by Comhairle na nOspidéal (the national body formerly responsible for regulating the appointments of consultant medical staff) found that the Republic was significantly short of consultant neurologists.