Refer to neurology by urgency tier: same-day emergency for acute focal deficits, expedited within days for progressive weakness or a suspected first seizure, and routine for stable persistent symptoms, diagnostic uncertainty or treatment failure. Patients must be 18 or older, and this practice provides no paediatric, inpatient, surgical or emergency care, so those pathways need a different provider.
Refer to neurology by urgency tier: same-day emergency for acute focal deficits, expedited within days for progressive weakness or a suspected first seizure, and routine for stable persistent symptoms, diagnostic uncertainty or treatment failure. Patients must be 18 or older, and this practice provides no paediatric, inpatient, surgical or emergency care, so those pathways need a different provider.
Acute focal neurological deficit, suspected stroke or transient ischaemic attack, status epilepticus or a first seizure still in progress, thunderclap headache, suspected meningitis, acute spinal cord compression with bladder or bowel involvement, and rapidly progressive weakness with any breathing or swallowing difficulty. These need an emergency department the same day. Sending them to an outpatient queue, however expedited, delays the treatment that would help.
Progressive weakness developing over days to weeks. A first unprovoked seizure that has already had acute assessment and needs classification and recurrence-risk discussion. Subacute cognitive decline over weeks. New-onset headache in an older patient or with red-flag features and normal initial imaging. Suspected giant cell arteritis needs immediate management rather than waiting for a neurology slot. Flag these explicitly with the reason, because the reason is what allows triage.
Stable persistent symptoms where the diagnosis is unclear after initial workup. Treatment failure after an adequate trial of first-line therapy. Chronic headache needing preventive strategy. Established neuropathy requiring localisation. Tremor and movement disorders. Known epilepsy needing review. For routine referrals, completeness matters more than speed: include the medication list, what has been excluded and what has been tried. Patients must be 18 or older; this practice provides no paediatric, inpatient, surgical or emergency care.
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, National Library of Medicine.
Adults 18 and older, at the Las Vegas and Henderson offices. Call 702-804-1212 or request an appointment online.