Neurology

Conditions

Please note this is not an exhaustive list of all conditions for outpatient services and does not exclude consideration for referral unless specifically stipulated in the out of scope section.

Pediatric services

Referrals for children and young people should follow the Children’s Health Queensland referral guidelines.

If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergent medical advice if in a remote region.

Headache/migraine

• Headache with concerning features:
  • sudden onset/thunderclap headache
  • severe headache with signs of systemic illness (fever, neck stiffness, vomiting, confusion, drowsiness)
  • first severe headache age > 50 years
  • severe headache associated with recent head trauma
  • headache with papilloedema
  • > 50 years with raised CRP/ESR or if giant cell arteritis or vasculitis suspected

Movement disorders

• Sudden onset of severe, disabling movement disorder

Progressive loss of neurological function

• Acute onset severe:
  • weakness
  • ataxia
  • vertigo
  • visual loss
• Acute severe exacerbation of known MS
• Acute myopathy, severe myasthenia exacerbation, GBS

Seizures/epilepsy

• Status epilepticus/epilepsy with concerning features:
  • first seizure
  • focal deficit post-ictally
  • seizure associated with recent trauma
  • persistent severe headache > 1 hour post-ictally
  • seizure with fever

Peripheral neuropathy

• Rapid (<2 weeks) progressive neuropathy where Guillain-Barre is suspected
• Sub-acute painful neuropathy where systemic vasculitis is suspected

Stroke/transient ischaemic attack (TIA)

• Patient with acute neurological symptoms of a stroke; multiple/crescendo TIA
• New acute symptoms

Suspected Idiopathic intracranial hypertension

• Papilloedema/suspected papilloedema or rapid onset visual loss

Other referrals to emergency

• Altered level of consciousness
• Bilateral limb weakness with or without bladder and/or bowel dysfunction
• Acute rapidly progressive weakness (Guillain-Barre Syndrome, myelopathy)
• Delirium/sudden onset confusion with or without fever

Out of scope services

Not all services are appropriate to be seen in the Queensland public health system. Exceptions can always be made where clinically indicated. It is proposed that the following are not routinely provided in a public Neurology Surgery service

The following are not routinely provided in a public Neurology Surgery service:

• Mild or tension headache
• Untreated headache/migraine
• Dementia without prior assessment by physician or geriatrician
• Syncope (consider Cardiology)
• Fibromyalgia/Chronic Fatigue syndrome
• Lyme Disease
• Head injury include post-concussion injury
• Radiculopathy or chronic back pain, see specific Spine CPC
• Chronic Unexplained Pain / Pain Syndrome
• Falls (refer to General Medicine CPC or Geriatrics first)
• Dizziness (To General Medicine first)
• Stroke rehabilitation (To Rehabilitation)
• Functional disorders that do not resemble Neurological conditions” e.g. functional blindness
• Concussion

Clinic details

Royal Brisbane and Women’s Hospital
Level 7, Ned Hanlon Building

The Prince Charles Hospital
Specialist Clinics, Ground Floor

Redcliffe Hospital
Level 1, Specialist Outpatient Department, Main Building

Specialists list