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Guidance

The following list of guidance, mostly from NICE, are of relevance to the work of clinicians at NHNN. Check the NICE website for guidance in other topic areas.

If you work at the NHNN and are considering auditing against a guideline please contact your departmental audit lead or the Quality and Clinical Governance Department (020 3448 3344 / QS-Governance@uclh.nhs.uk) for advice. See also, for UCLH intranet users onlyUCLH guidelines and NHNN Guidelines.

Brain cancers

  • AlignRT for intracranial stereotactic radiosurgery - MIB147
  • Artificial intelligence for analysing CT brain scans - MIB207 
  • Brain tumours (primary) and brain metastases in adults - NG99 
  • Brain tumours (primary) and brain metastases in adults - Quality standard QS203 
  • Carmustine implants and temozolomide for the treatment of newly diagnosed high-grade glioma - TA121
  • Entrectinib for treating NTRK fusion-positive solid tumours - TA644 
  • Guidance on the use of temozolomide for the treatment of recurrent malignant glioma (brain cancer) - TA23
  • Improving outcomes for people with brain and other central nervous system tumours - CSG10
  • Nivolumab for treating recurrent or metastatic squamous cell carcinoma of the head and neck after platinum-based chemotherapy - TA736 
  • Pembrolizumab for untreated metastatic or unresectable recurrent head and neck squamous cell carcinoma - TA661 
  • Photodynamic therapy for brain tumours - IPG290
  • Suspected neurological conditions: recognition and referral - quality standard QS198 

Cerebral palsy

  • Cerebral palsy in adults - NG119 
  • Cerebral palsy in children and young people - QS162
  • Cerebral palsy in under 25s: assessment and management - NG62
  • Quality Standard: Cerebral palsy in adults - QS191 
  • Severe sialorrhoea (drooling) in children and young people with chronic neurological disorders: oral glycopyrronium bromide - ES5
  • The Vest for delivering high-frequency chest wall oscillation in people with complex neurological needs - Medtech innovation briefing - MIB159 

Delerium

  • Delirium in adults quality standard - QS63
  • Delirium: prevention, diagnosis and management - CG103

Dementia

  • Antipsychotics in people with dementia - key therapeutic topic KTT7
  • Dementia: assessment, management and support for people living with dementia and their carers - NG97 
  • Dementia Quality standard - QS184 
  • Dementia: support in health and social care quality standard - QS1
  • Dementia, disability and frailty in later life – mid-life approaches to delay or prevent onset - NG16
  • Donepezil, galantamine, rivastigmine and memantine for the treatment of Alzheimer's disease - TA217
  • Independence and wellbeing quality standard - QS30
  • Supporting people with dementia and their carers in health and social care - CG42

Epilepsy

  • 24/7 EEG SubQ for epilepsy Medtech innovation briefing - MIB277 
  • Cannabidiol with clobazam for treating seizures associated with Dravet syndrome - TA614 
  • Cannabidiol with clobazam for treating seizures associated with Lennox–Gastaut syndrome - TA615 
  • Cenobamate for treating focal onset seizures in epilepsy - TA753 
  • Deep brain stimulation for refractory epilepsy - IPG416
  • Deep brain stimulation for refractory epilepsy in adults - IPG678 
  • Diagnosis and management of epilepsy in adults - SIGN143 
  • Epilepsies diagnosis and management - CG137
  • Epilepsy in adults quality standard - QS26
  • MRI-guided laser interstitial thermal therapy for drug-resistant epilepsy - IPG671
  • Retigabine for the adjunctive treatment of partial onset seizures in epilepsy - TA232

Fabry disease

  • Migalastat for treating Fabry disease - highly specialised technologies guidance - HST4

Head injury / Brain injury

  • Brain injury rehabilitation in adults - SIGN130 
  • Assessment and early management - CG176
  • Head injury quality standard - QS74

Headache & Migraine

  • Botulinum toxin type A for the prevention of headaches in adults with chronic migraine - TA260
  • Deep brain stimulation for intractable trigeminal autonomic cephalalgias - IPG381
  • Erenumab for preventing migraine - TA682 
  • Fremanezumab for preventing migraine - TA631 
  • Galcanezumab for preventing migraine - TA659 
  • gammaCore for cluster headache - Medtech innovation briefing - MIB162 & Medical technologies guidance - MTG46 
  • Headaches in over 12s: diagnosis and management - CG150
  • Implantation of a sphenopalatine ganglion stimulation device for chronic cluster headache - IPG527
  • Occipital nerve stimulation for intractable chronic migraine - IPG452
  • Percutaneous closure of patent foramen ovale for recurrent migraine - IPG370
  • Transcutaneous electrical stimulation of the supraorbital nerve for treating and preventing migraine - IPG559
  • Transcranial magnetic stimulation for treating and preventing migraine - IPG477
  • Transcutaneous stimulation of the cervical branch of the vagus nerve for cluster headache and migraine - IPG552

Incontinence: fecal and urinary

  • Urinary incontinence in neurological disease: assessment and management - CG148

Lifestyle and wellbeing

  • Physical activity: Ekso exoskeleton for rehabilitation in people with neurological weakness or paralysis - Medtech innovation briefing - MIB93

Medicine management

  • Antipsychotics in people living with dementia: Key therapeutic topic - KTT7

Motor neurone disease

  • Guidance on the use of Riluzole (Rilutek) for the treatment of MND - TA20
  • Intramuscular diaphragm stimulation for ventilator-dependent chronic respiratory failure caused by motor neurone disease - IPG593
  • MND: assessment and management - NG42
  • MND: non-invasive ventilation - CG105
  • MND: quality standard - QS126

Multiple sclerosis

  • Alemtuzumab for treating relapsing‑remitting multiple sclerosis - TA312
  • Beta interferons and glatiramer acetate for treating multiple sclerosis - TA527 (replaces TA32)
  • Cladribine for treating relapsing–remitting multiple sclerosis - TA616 (replaces previous TA493)
  • Daclizumab for treating relapsing–remitting multiple sclerosis - TA441
  • Deep brain stimulation for tremor and dystonia (excluding Parkinson's disease) - IPG188
  • Dimethyl fumarate for treating relapsing‑remitting multiple sclerosis - TA320
  • Fingolimod for the treatment of highly active relapsing–remitting multiple sclerosis - TA254
  • Functional electrical stimulation for drop foot of central neurological origin - IPG278 
  • Management of MS in adults - CG186
  • MS quality standard: QS108
  • Natalizumab for the treatment of adults with highly active relapsing–remitting multiple sclerosis - TA127
  • Ocrelizumab for treating primary progressive multiple sclerosis - TA585 
  • Ocrelizumab for treating relapsing–remitting multiple sclerosis - TA533 
  • Ofatumumab for treating relapsing multiple sclerosis - TA699 
  • Ozanimod for treating relapsing–remitting multiple sclerosis - TA706  
  • Peginterferon beta-1a for treating relapsing–remitting multiple sclerosis - TA624 
  • Percutaneous venoplasty for chronic cerebrospinal venous insufficiency in multiple sclerosis - IPG640 (replaces IPG420)
  • Siponimod for treating secondary progressive multiple sclerosis - TA656 
  • Teriflunomide for treating relapsing–remitting multiple sclerosis - TA303

Pain

  • Chronic pain (primary and secondary) in over 16s: assessment of all chronic pain and management of chronic primary pain - NG193 
  • Deep brain stimulation for refractory chronic pain syndromes (excluding headache) - IPG382
  • Management of chronic pain - SIGN136 
  • Medicines optimisation in chronic pain - Key therapeutic topic KTT21 
  • Neuropathic pain in adults: pharmacological management in non-specialist settings - CG173
  • Percutaneous electrical nerve stimulation for refractory neuropathic pain - IPG450
  • Percutaneous interlaminar endoscopic lumbar discectomy for sciatica - IPG555
  • Percutaneous transforaminal endoscopic lumbar discectomy for sciatica - IPG556
  • Senza spinal cord stimulation system for delivering HF10 therapy to treat chronic neuropathic pain - Medical technologies guidance - MTG41 
  • Spinal cord stimulation for chronic pain of neuropathic or ischaemic origin - TA159
  • Stereotactic radiosurgery for trigeminal neuralgia using the gamma knife - IPG085
  • Transcranial MRI-guided focused ultrasound thalamotomy for neuropathic pain - IPG632 

Parkinson's

  • Deep brain stimulation for Parkinson's disease - IPG19
  • Parkinson’s disease in adults: guideline - NG71
  • Parkinson's disease in over 20s: diagnosis and management - CG35
  • Parkinson's disease quality standard - QS164
  • Parkinson’s disease with end-of-dose motor fluctuations: opicapone - ES9
  • Parkinson’s disease with motor fluctuations: safinamide - ES6
  • Subthalamotomy for Parkinson's disease - IPG065
  • Unilateral MRI-guided focused ultrasound thalamotomy for moderate to severe tremor in Parkinson’s disease - IPG606

Spasticity

  • Selective dorsal rhizotomy for spasticity in cerebral palsy - IPG373
  • Spasticity in under 19s: management - CG145

Spinal cord

  • Balloon kyphoplasty for vertebral compression fractures - IPG166
  • Chronic spinal cord injury : management of patients in acute hospital settings - RCP guidelines
  • Diagnosis and management of adults at risk of and with metastatic spinal cord compression - CG75
  • Direct C1 lateral mass screw for cervical spine stabilisation - IPG146
  • Evoke Spinal Cord Stimulator for managing chronic neuropathic or ischaemic pain - Medtech innovation briefing MIB238 
  • Intramuscular diaphragm stimulation for ventilator-dependent chronic respiratory failure caused by high spinal cord injuries - IPG594
  • Percutaneous vertebroplasty - IPG012
  • SecurAcath for securing cerebrospinal fluid catheters: Medtech innovation briefing - MIB107

Stroke

  • Alteplase for treating acute ischaemic stroke - TA264
  • Apixaban for preventing stroke and systemic embolism in people with nonvalvular atrial fibrillation - TA275
  • Atrial fibrillation: diagnosis and management - NG196 
  • Cerebrotech Visor for detecting stroke: Medtech innovation briefing MIB165 
  • Dabigatran etexilate for the prevention of stroke and systemic embolism in atrial fibrillation - TA249
  • Edoxaban for preventing stroke and systemic embolism in people with non-valvular atrial fibrillation - TA355 
  • Extracranial to intracranial bypass for intracranial atherosclerosis - IPG348
  • Implementing the National Stroke Strategy - an imaging guide - DoH9963
  • Inducing and maintaining normothermia using temperature modulation devices to improve outcomes after stroke or subarachnoid haemorrhage - IPG701 
  • IQoro for stroke-related dysphagia: Medtech innovation briefing - MIB175
  • Mechanical clot retrieval for treating acute ischaemic stroke - IPG548
  • Mechanical thrombectomy devices for acute ischaemic stroke - Medtech innovation briefing MIB153 
  • RCP stroke guidelines
  • Percutaneous insertion of a cerebral protection device to prevent cerebral embolism during TAVI - IPG650 
  • RapidAI for analysing CT/MRI brain scans in people with suspected acute stroke - Medtech innovation briefing MIB262 
  • ReStore Soft Exo-Suit for gait rehabilitation - Medtech innovation briefing MIB239 
  • Rivaroxaban for the prevention of stroke and systemic embolism in people with atrial fibrillation - TA256 
  • Stroke and transient ischaemic attack in over 16s: diagnosis and initial management - NG128 (replaces CG68)
  • Stroke in adults - QS2
  • Stroke rehabilitation in adults - CG162
  • Therapeutic hypothermia for acute ischaemic stroke - IPG647 
  • Transcervical extracorporeal reverse flow neuroprotection for reducing the risk of stroke during carotid artery stenting - IPG561

Surgery

  • Endovascular insertion of an intrasaccular wire-mesh blood-flow disruption device for intracranial aneurysms - IPG658 
  • Guidance on the use of ultrasound locating devices for placing central venous catheters - TA49
  • Lumbar subcutaneous shunt - IPG068
  • Prevention and treatment of surgical site infection - CG74
  • Reducing the risk of transmission of Creutzfeldt–Jakob disease (CJD) from surgical instruments used for interventional procedures on high-risk tissues - IPG666 
  • The use of routine preoperative tests for elective surgery - CG3

Transient loss of consciousness

  • Transient loss of consciousness ('blackouts') in over 16s - CG109
  • Transient loss of consciousness ('blackouts') in over 16s quality standard - QS71

Miscellaneous neurological topics

  • Ataluren for treating Duchenne muscular dystrophy with a nonsense mutation in the dystrophin gene - HST3
  • Cerliponase alfa for treating neuronal ceroid lipofuscinosis type 2 - HST12 
  • Coil embolisation of ruptured intracranial aneurysms - IPG106
  • Eculizumab for treating refractory myasthenia gravis (terminated appraisal) - TA636 
  • Hypnotics - key therapeutic topic KTT6
  • Nerve transfer to partially restore upper limb function in tetraplegia - IPG610
  • Patient safety and reduction of risk of transmission of Creutzfeldt-Jakob disease via interventional procedures - IPG196
  • pCONUS2 Bifurcation Aneurysm Implant for complex intracranial aneurysms - Medtech innovation briefing MIB222 
  • Processed nerve allografts to repair peripheral nerve discontinuities - IPG597
  • Selective peripheral denervation for cervical dystonia - IPG080
  • Severe sialorrhoea (drooling) in children and young people with chronic neurological disorders: oral glycopyrronium bromide - ES5
  • Supraorbital minicraniotomy for intracranial aneurysm - IPG084
  • Suspected neurological conditions: recognition and referral - NG127 
  • Transcutaneous neuromuscular electrical stimulation for oropharyngeal dysphagia - IPG490
  • Unilateral MRI-guided focused ultrasound thalamotomy for treatment-resistant essential tremor - IPG617