Rehabilitation for chronic neurological disorders including acquired brain injury

  • NICE guideline
  • NG252
  • Published: 
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Inclusions and exclusions

Inclusions

Note there may be diseases, disorders and injuries that are not included in these lists but where the resulting neurological impairment or disabling neurological symptoms would still be covered by this guideline.

Progressive neurological disease

Disorders that involve a gradual progression of neurological difficulties over time. This includes congenital disorders that result in long-term chronic neurological disorders, impairment and symptoms and where there is a progressive need for neurorehabilitation (for example, as children grow).

  • Parkinson-plus syndrome

  • Parkinson's disease

  • progressive supranuclear palsy

  • corticobasal degeneration

  • multiple sclerosis

  • multiple system atrophy

  • motor neurone disease:

    • amyotrophic lateral sclerosis (also known as Lou Gehrig's disease and Charcot's disease)

    • primary lateral sclerosis

    • progressive muscular atrophy

    • progressive bulbar palsy

    • Kennedy's disease (also known as progressive spinobulbar muscular atrophy)

    • Post-Polio Syndrome

    • spinal muscular atrophy

  • muscular dystrophy, for example, Duchenne muscular dystrophy

  • Friedreich's ataxia

  • Huntington's disease

  • Batten disease

  • white matter disorders, for example, metachromatic leukodystrophy

  • mitochondrial myopathy

  • mucopolysaccharidosis (lysosomal storage disorders)

  • primary dystonia

  • spina bifida

  • other genetic disorders, for example, Williams syndrome, catch 22 disease, Rett syndrome, hereditary spastic paraplegia, hereditary motor neuropathy and hereditary sensory autonomic neuropathy.

Acquired brain injury

Injuries to the brain that result in neurological impairment. Possible causes covered by this guideline are:

  • tumours

  • traumatic injury, including shaken baby syndrome

  • chronic encephalitis

  • chronic hydrocephalus

  • hypoxic brain injury, including near drowning

  • chronic and persistent neurological symptoms as a result of infection:

    • viral causes, for example, polio and AIDS

    • bacterial causes, for example, neuro-syphilis and tuberculosis

  • alcohol or drug induced brain injury

  • stroke in under-16s.

Acquired spinal cord injury

Injuries to the spinal cord that result in neurological impairment. Possible causes are:

  • tumours

  • traumatic injury

  • chronic and persistent neurological symptoms as a result of infection:

    • viral causes, for example, polio and AIDS

    • bacterial causes, for example, neuro-syphilis and tuberculosis

  • vascular infarction or haemorrhage (including arteriovenous malformation bleed)

  • transverse myelitis.

Acquired peripheral nerve disorder

Acute-onset disorders of the peripheral nervous system that result in neurological impairment. Causes may be inflammatory, autoimmune or paraneoplastic:

  • inflammatory-related causes, for example, chronic inflammatory demyelinating neuropathy

  • alcohol induced nerve disorders

  • diabetic neuropathy

  • motor or sensory neuropathy

  • Guillain-Barre syndrome

  • autoimmune-related causes:

    • for example, multi focal motor neuropathy, Lupus and Sjögren's syndrome

    • from infections, for example, chicken pox, West Nile, herpes, Lyme disease and HIV

  • paraneoplastic-related causes, for example, from tumour or neoplasm.

Functional neurological disorder

A disorder causing a range of disabling neurological symptoms, which include altered awareness, motor and sensory changes; however, symptoms are not explained by a physical or neurological disease. Also sometimes referred to as:

  • functional neurological symptom disorder

  • functional movement disorder

  • conversion disorder

  • cognitive dysfunction

  • psychogenic seizures

  • movement disorder

  • dissociative seizures

  • motor disorder

  • non-epileptic seizures.

Exclusions

This guideline does not cover disorders for which interventions are primarily focused on altering body structure and functions, for example, isolated peripheral nerve injury (single nerve or plexus injury) or autonomic neuropathy, where management is primarily non-rehabilitation.