What are the referral criteria for a patient with suspected myopathy to a neurologist?

Referral criteria for suspected myopathy to a neurologist:

• Refer adults with slowly progressive (weeks to months) limb or neck weakness for assessment of neuromuscular disorders, which includes myopathies.

• Urgently refer if there is any evidence of swallowing impairment, as this may indicate bulbar involvement.

• Refer immediately if there is breathlessness at rest or when lying flat, indicating possible respiratory muscle involvement.

These criteria ensure timely neurological assessment for diagnosis and management of suspected myopathy.

Note: Rapidly progressive symmetrical limb weakness (within 4 weeks) also requires immediate referral for neurological assessment, which may include myopathy differential diagnosis.

These recommendations are based on the NICE guideline on suspected neurological conditions: recognition and referral ¹.