Refer to neurology when the diagnosis remains unclear after initial workup, when first-line treatment has failed, when the presentation is progressive, or when electrodiagnostic or EEG assessment is needed to localise a problem. Acute severe presentations go to an emergency department instead.
Refer to neurology when the diagnosis remains unclear after initial workup, when first-line treatment has failed, when the presentation is progressive, or when electrodiagnostic or EEG assessment is needed to localise a problem. Acute severe presentations go to an emergency department instead.
Diagnostic uncertainty after reasonable initial assessment. Treatment failure, where an adequate trial of first-line therapy has not worked. Progression, where the trajectory itself is the concern regardless of current severity. And the need for a localising study, since electrodiagnostic testing and EEG answer questions that history and imaging cannot.
Headache when the pattern has changed, frequency is escalating or analgesic use is high. Sensory symptoms that are persistent, progressive or accompanied by weakness. Episodic events where a seizure is in the differential, ideally with a witness account. Cognitive change affecting function, after reversible contributors have been screened. Tremor, gait disturbance and suspected neuromuscular disease.
Acute severe presentations belong in an emergency department: sudden focal deficit, new speech disturbance, sudden vision loss, thunderclap headache, first seizure in progress, or new confusion. Patients under 18 need paediatric neurology. Anything requiring surgery, admission or infusion therapy is outside this practice's scope.
Clinical Neurology Specialists has been physician-owned since 1998, when Leo Germin, M.D., FAANEM founded it. Five board-certified neurologists and four advanced practice providers see patients at the Las Vegas and Henderson offices, each with its own AANEM-accredited electrodiagnostic laboratory.
Clinical Neurology Specialists is an adult outpatient neurology practice for patients 18 and older. The practice performs no surgery and operates no imaging suite, infusion suite or interventional pain programme, and provides no emergency or inpatient care.
The practice referral form is available as a PDF, and a Spanish version is available for patients who prefer it.
Physician-reviewed. Reviewed by the physicians of Clinical Neurology Specialists — board-certified neurologists, AANEM-accredited electrodiagnostic laboratories, physician-owned since 1998. Reviewed 1 August 2026. This article is general education for adults 18 and older and is not a substitute for a consultation.
Sources and further reading: American Academy of Neurology; American Association of Neuromuscular & Electrodiagnostic Medicine; MedlinePlus: peripheral nerve disorders.
Adults 18 and older, at the Las Vegas and Henderson offices. Call 702-804-1212 or request an appointment online.