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Just how do you know which neurology expert you need?

[IT IS FREQUENTLY EASY to identify the specialism from which an expert should be drawn. In the case of a neurological injury, however, it may not be that simple.

It may not be obvious whether a physician’s or a surgeon’s opinion is required: whether a neuropsychiatrist, neuropsychologist or neurosurgeon, for example, is required; and in today's increasingly cost-conscious justice system, choosing the correct expert in the first place has become even more important.

The are a number of types of case where neurological expertise is sought. In civil cases there may be a claim for clinical negligence or for personal injury – which in turn may result from an accident at work, a road traffic accident or other accident.

Criminal cases may involve an assault or the need to determine state of mind at the time of an offence, while the Court of Protection may be called upon to determine capacity either to grant power of attorney or rule on the validity of a will.

The range of specialisms encompassed within the sphere of neurology is reflected in the membership of the British Neurological Society.

A facet of neurological injury that has come into the public eye recently has been in the realm of sports injury – particularly football and rugby. Anyone watching international rugby matches has become used to the sight of the head injury assessment – the three-stage assessment for concussion after an impact.

Over the past year a number of lawsuits have been initiated by both amateur players and household names in both rugby union and league.

In football head injuries have become a cause for concern in recent years. Heading the ball is now banned among children under 12 in Scotland and in England as a trial.

The Advanced Brain Health Clinic at the Institute of Sport, Exercise and Health (ISEH) is a unique neurological service for retired elite rugby and football players who have concerns about their brain health and its team are embarking on a study into the long-term brain health of retired elite athletes.

The kind of neurological and psychiatric problems that football and rugby players are at risk of developing includes post-traumatic dementias, such as chronic traumatic encephalopathy (CTE).

The prevalence of brain health issues is unclear, the ISEH says, so it is crucial to understand it further.

The future development of the cases brought by those sportspeople may shed further light on the broad range of specialisms to be found among neurological expert witnesses. q

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