ABSTRACT
Z. J. Lipowski and R. Kiriakos reviewed 200 neurological inpatients referred to a liaison service. In the assessment of a patient with neurological symptoms, as in all liaison work, the history is of paramount significance. The liaison psychiatrist may be asked to help with the diagnosis if the typical combination of choreiform movements, psychiatric disorder and family history is absent. The liaison psychiatrist's chief concerns are diagnosis, absolute and proportional — the input of organic and psychological factors, respectively — and management. Diagnoses which have usually been excluded before a liaison request for persistent facial pain is made are local infection, temporomandibular arthritis, parotid disease, cranial arteritis and post-herpetic neuralgia. Acute single episodes of headache are important, but are not the province of the liaison psychiatrist. In ancient Babylon the prestigious priest-physician dealt with mental disorders and internal medicine, whereas lesser, lay practitioners coped with the obvious, for instance injuries.
