Curriculum for General Practice - The Royal New Zealand College ...

Neurology
N
Neurology
Neurological disorders are common. They
may be a single diagnosis or part of a
complex disease pattern. Many conditions
have no cure and so health care is based
on alleviating symptoms. Neurological
problems lead to significant disability even
if their origin is benign, such as migraine.
For many, the disabling effects result in lost
working days. The effects on families and
communities can be life-changing.
Parkinson’s, Alzheimer’s, multiple sclerosis, Huntington’s,
and motor neurone diseases, stroke, migraine, epilepsy and
traumatic brain injury are just a few of the wide spectrum of
disorders that general practitioners consult on.
By 2051, it is estimated almost a third of New Zealanders
will be aged 65 and over and 2.7 percent of the population
will have dementia, and new cases will comprise
0.8 percent of the population each year after. Dementia
cases are expected to increase unless a cause, effective
treatments or, ultimately, a cure can be found. This has
major implications for the New Zealand health care system,
as well as economic and social impacts. 1
Additionally, the incidence of stroke is rising and, while it is
currently the third leading cause of death after cancer and
heart disease, it is predicted in time to become the primary
cause of death and disability in New Zealand. Stroke is a
preventable disease, but it is estimated that over 7,000
New Zealanders experience a stroke every year, and
at least three-quarters of these people will die or be
dependent on others for care a year later, which again has
significant implications for the nation as a whole. 2
Health inequities are apparent in stroke statistics, with
the average age of stroke onset for Māori at 61 years,
compared to 64 years for Pacific people and over 75 years
for Europeans, 3 with some evidence suggesting that the
chance of being dependent at 12 months following a stroke
is three times higher for Māori compared to Europeans. 4
1
http://www.alzheimers.org.nz/assets/Reports/AnnualReports/Dementia_Economic_Impact_Report2008.pdf
2
http://www.msd.govt.nz/about-msd-and-our-work/publications-resources/journals-and-magazines/social-policy-journal/spj33/33-stroke-a-picture-of-health-disparitiesin-new-zealand-p178-191.html
3
Feigin V, K. Carter K et al. (2006) “Ethnic disparities incidence of stroke subtypes: Auckland Regional Community Study” Neurology: The Lancet, 5(1):130-139.
4
McNaughton H, Weatherall M et al. (2002) “The comparability of community outcomes for European and non-European survivors of stroke in New Zealand”
New Zealand Medical Journal, 115(1149):98-100.
5
http://www.brain-injury.org.nz/index.html
www.rnzcgp.org.nz
Curriculum for General Practice
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