When should I consider referring a patient with suspected MND to a specialist, and what information should I include in the referral?

Refer a patient with suspected motor neurone disease (MND) without delay and specify the possible diagnosis in the referral letter ¹.

Contact the consultant neurologist directly if you think the person needs to be seen urgently ¹.

Refer for assessment if there is slowly progressive limb or neck weakness, especially if there is evidence of swallowing impairment or respiratory symptoms such as breathlessness at rest or when lying flat ¹.

Consider immediate referral for adults with rapidly (within 4 weeks) progressive symmetrical limb weakness, or very rapidly (within hours to days) progressive weakness of a single limb or hemiparesis ¹.

Refer immediately if there is sudden-onset limb or facial weakness, or severe low back pain with neurological symptoms suggestive of cauda equina syndrome ¹.

Include in the referral: the suspected diagnosis, details of symptom onset and progression, specific neurological signs, and any relevant investigations or findings ¹.