I have had a string of patients with neurological complaints in which I don't know if I am working them up too much or not enough. I don't want to be the guy who either admits all neuro complaints or the one missing strokes! Here are some examples: 1) 70 year old male with HTN and hyperlipidemia came in at 2am for chronic right shoulder pain worsening that evening, but also woke up with right facial numbness lasting <10 minutes (wife wanted him to go to the ER incase it was a stroke). Guy is more worried about his shoulder and neuro exam completely normal. Shoulder only hurts with ROM. Head CT is normal. 2) 35 year old male sent from PCP's office because patient states "she wanted to cover-her-ass" after he showed up with right handgrip weakness. Patient is vague and says it he can't remember when it started, but might have been yesterday. His right hand is noticeably weaker, but everything else normal and he has absolutely no medical history (not really a lacunar - clumsy hand syndrome-ish). Patient is annoyed he was sent by EMS to the ER from the office just for this complaint. With all of these...arm/face numbness, tingling, vague neuro complaints how do you sort them out and decide on whether you work them up? Do you ever get a head CT and then if normal send home? I feel this is dangerous because you have entertained the idea of a stroke and haven't fully worked it up with an MRI, which I feel would be hard to defend in court if something happened. Thanks in advance!