The patient with neurological and psychological disorders

Neurological conditions may affect the brain, spinal cord or peripheral nerves. Some are life threatening and may be severely detrimental to quality of life and cause lifelong disability. The majority are long-term conditions and occur with greater frequency with advancing age. It is estimated that 8 million people in the UK are affected by a neurological condition. Patients with neurological disease are at increased risk of perioperative complications; several common themes emerge including problems with timing of medications, management of common co-morbid disease and increased incidence of healthcare acquired infection and venous thromboembolism.Disorders of mental health are a leading cause of disease burden worldwide, depression in particular is extremely prevalent. Increasingly patients presenting for surgery are taking prescribed psychoactive medications with important implications for perioperative management which will be discussed in further detail.