Skip to main content

Consultant neurology · UK

The comprehensive neurological examination, by a consultant neurologist.

A structured bedside assessment of nervous system function - cognition, cranial nerves, motor, sensory, coordination and gait - performed to Association of British Neurologists standard, and used to localise the problem before you have a single scan.

See indicative pricing
A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What a neurology consultation costs in the UK.

NHS neurology is free via GP referral but waits are 6–52 weeks.

In short

£250–£500, usually within 1–2 weeks.

Appointment Indicative range
New-patient neurology consultation (private) £250–£500
Follow-up neurology consultation £180–£350
Cognitive assessment (MMSE/MoCA) £300–£600
Subspecialty consultation (MS, movement, epilepsy) £300–£600
Second opinion (with imaging review) £400–£750
NHS neurology (GP referral) Free

Prices vary by consultant, by hospital, by subspecialty and by whether cognitive testing or imaging review is included.

The problem

Localise the problem first, then scan.

Neurology is the specialty in which examination still leads the diagnosis. A ten-minute look at the wrong scan will not do what fifteen minutes at the bedside can.

  • A scan without a question

    MRI reports without a clinical question return incidental findings and no answers. The exam writes the question.

  • The wrong subspecialty

    A headache clinic will not read a Parkinsonian gait; an MS clinic will not run a MoCA properly.

  • The NHS wait

    Routine neurology waits are 6–52 weeks in most trusts. Private cuts the wait, without replacing NHS follow-up if you already have one.

When it helps

When a neurological examination is the right next step.

The presentations we see most, plus the red flag that means an emergency rather than an appointment.

  • Headache and migraine

    New, worsening or atypical headache - the exam rules out secondary causes and guides imaging.

  • Stroke or TIA follow-up

    Assessment of residual deficit, secondary prevention and rehabilitation planning after a cerebrovascular event.

  • Weakness or numbness

    Localises the lesion - cortex, spinal cord, root, nerve or muscle - and directs MRI or nerve studies.

  • Tremor or movement disorder

    Parkinson’s, essential tremor, dystonia - assessed for bradykinesia, tone, postural stability and gait.

  • Memory or cognitive change

    A formal MMSE or MoCA plus higher-function testing, in the setting of a full neurological examination.

  • Dizziness and vertigo

    Vestibular and cerebellar examination, cranial nerves and gait - to separate central from peripheral causes.

  • Seizure or blackout

    History-led assessment with cognitive, cranial-nerve and motor examination - followed by EEG and MRI where indicated.

  • Red flag: sudden focal deficit

    Sudden weakness, speech loss, facial droop or severe thunderclap headache is an emergency - 999 or A&E, not a clinic booking.

What the exam covers

Eight sections, one systematic pass.

What each section of the ABN-standard examination actually tests - and what an abnormal finding tells the neurologist to do next.

  • Cognition and higher function

    Orientation, attention, memory, language, praxis, gnosis and visuospatial function - with formal MMSE or MoCA where indicated.

  • Cranial nerves I–XII

    Olfaction, vision and fundoscopy, eye movements, facial sensation and movement, hearing, palate, tongue and shoulder - examined in order.

  • Motor system

    Bulk, tone, MRC 0–5 power, and reflexes - biceps, triceps, brachioradialis, knee, ankle, plantar, clonus and Hoffman - in all four limbs.

  • Coordination and cerebellar

    Finger–nose, heel–shin, dysdiadochokinesia, Romberg, nystagmus, dysarthria and gait ataxia.

  • Sensory

    Light touch, pinprick, temperature, 128 Hz vibration, proprioception and cortical sensation - graphaesthesia, stereognosis, two-point discrimination.

  • Gait and posture

    Normal walking, tandem, heel and toe walking, turn, and postural stability - the single most informative bedside test.

  • Special tests

    SLR, femoral stretch, Spurling, Lhermitte, Kernig and Brudzinski, Hoover for functional weakness - chosen for the clinical question.

  • Adjunctive examination

    Fundoscopy for papilloedema or optic atrophy, otoscopy, carotid bruits, orthostatic blood pressure and a brief functional assessment.

What to expect

What the appointment is really like.

A neurological examination is safe, non-invasive and thorough. What matters is preparation, the right question and what happens after.

  • The history does most of the work

    Most neurological diagnoses are made in the history - the exam confirms and localises. Bring a timeline, a medication list and, if you can, a witness account.

  • The exam is thorough, not uncomfortable

    A full examination takes 15–25 minutes. It uses a tendon hammer, tuning fork, cotton wool, ophthalmoscope and a small torch - nothing invasive.

  • Localisation before investigation

    A good exam separates upper from lower motor neurone, central from peripheral, focal from global - which decides whether you need MRI brain, MRI spine, EMG or blood work.

  • Cognitive testing is a screen, not a verdict

    MMSE and MoCA are useful bedside tools. A low score prompts formal neuropsychology - it does not, on its own, diagnose dementia.

  • Fundoscopy matters

    Looking at the back of the eye picks up papilloedema, diabetic retinopathy and optic atrophy - findings that change the plan the same afternoon.

  • Functional signs are real signs

    Functional neurological disorder (FND) is a positive diagnosis with specific signs - Hoover’s, tremor entrainment, distractibility - not a diagnosis of exclusion.

  • Bring your imaging

    If you have had an MRI, CT, EEG or nerve conduction study elsewhere, bring the images and the report - not just a summary letter.

  • A single exam is a snapshot

    Some conditions - early MS, movement disorders, episodic problems - need a repeat exam over months. A normal exam today does not close the door.

  • Red flags

    Sudden weakness, sudden speech loss, facial droop, thunderclap headache, or new seizure are emergencies - call 999 or go to A&E the same day.

Reading your consultation letter

Your neurology letter in four parts. Read the last one first.

Whatever subspecialty you see, the letter that lands with you and your GP keeps to the same shape.

A UK consultant neurologist reviewing a patient’s consultation letter

A quiet reminder

Neurology language is precise and can read coldly - we translate it for you.

If you would like us to talk you through the letter before your follow-up, just ask.

  1. 01 History

    The story, in the neurologist’s words

    Onset, pattern, triggers, red flags, medications and relevant family history - written back so you can check it is right.

  2. 02 Examination

    What was normal, what was not

    Cognition, cranial nerves, motor, sensory, coordination and gait - each section, with the abnormalities named plainly.

  3. 03 Localisation

    Where the problem sits

    UMN vs LMN, central vs peripheral, focal vs global - the anatomical answer that the exam was designed to give.

  4. 04 Plan

    Investigations, treatment and follow-up

    Read this first: MRI, EEG, EMG, lumbar puncture or blood tests as needed, a working diagnosis, and when to come back.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Consultant neurology is usually covered by most UK insurers with a GP referral.

Frequently asked

Everything we get asked about neurological examinations.

Quick answers on cost, what to bring, what the exam covers, and what happens after.

  • What is a neurological examination?

    A structured, bedside assessment of nervous system function by a consultant neurologist. It covers cognition, all twelve cranial nerves, the motor and sensory systems, coordination, reflexes and gait - following the standard taught by the Association of British Neurologists.

  • How long does the appointment take?

    A new-patient consultation runs 30–45 minutes - usually 15–20 minutes of history followed by a 15–25 minute examination. Follow-ups are 15–30 minutes.

  • What does a private neurology consultation cost in the UK?

    Roughly £250–£500 for a new-patient consultation, £180–£350 for a follow-up, and £300–£600 for a subspecialty or cognitive assessment. NHS neurology is free via GP referral, with waits of 6–52 weeks depending on region and urgency.

  • Do I need a GP referral?

    Insurers usually require one. For self-pay you can be seen without a referral, though a GP letter and any prior imaging or blood work make the consultation far more useful.

  • What should I bring to the appointment?

    A written timeline of symptoms, a full medication list, a witness account if you have had blackouts or memory concerns, and any previous imaging (MRI or CT on disc), EEG, EMG or blood results.

  • Will I need a scan on the day?

    Rarely. The exam is designed to decide which scan you need - brain MRI, spine MRI, CT, or none - and to book it in the right sequence with contrast if required.

  • What is the difference between an upper and lower motor neurone problem?

    Upper motor neurone lesions (brain or spinal cord) cause weakness with increased tone, brisk reflexes and an upgoing plantar. Lower motor neurone lesions (nerve or muscle) cause weakness with wasting, reduced tone, reduced reflexes and fasciculations. The exam separates the two - it decides whether the next scan is brain, spine or nerve.

  • What conditions is a neurological exam used for?

    Headache, stroke and TIA, multiple sclerosis, Parkinson’s and other movement disorders, epilepsy, peripheral neuropathy, dementia and cognitive decline, radiculopathy and myelopathy, cranial neuropathies including Bell’s palsy and trigeminal neuralgia, functional neurological disorder, vestibular disorders, sleep disorders and muscle disease.

  • What happens after the examination?

    You leave with a working diagnosis or differential, a plan for further tests - commonly MRI, EEG, nerve conduction with EMG, or blood work - and a follow-up date. A full letter goes to you and your GP within a few days.

Related treatments

Looking for something else?