Mater Specialist Quick Find

Neurology – public patients 

Purpose

This page contains information for general practitioners on how to refer patients aged 16 years and over to Neurology services at Mater Hospital Brisbane. 

Service: 

Mater offers a comprehensive neurology service for public patients through the Mater Centre for Neurosciences. Consisting of surgeons, physicians, nurses and allied health professionals, the Mater Centre for Neurosciences is designed to meet the specific needs of patients and their families. 

In addition to general Neurology services, patients can be referred to dedicated clinics for 

  • Advanced / Surgical Epilepsy Clinic - requires a neurologist referral 
  • Functional Neurological Disorders Clinic - requires a neurologist referral
  • Mater Memory Clinic - a tertiary referral service for adult patients with memory and related cognitive complaints. Owing to the high prevalence of dementia and related disorders, we regret that we can only offer a service for referrals from specialists. For patients: It is essential that when you come to your appointment, that you attend with a close relative or friend

How to Refer: 

If referral for care is indicated please list all of the General Referral Information and reason for request, and essential information as indicated below.

To refer, please fill in the Mater Adult Referral Form, available to download and embed into most major Practice Management software applications.

Referrals can be sent by:

Secure messaging  Medical Objects:   HM4101000R8
  HealthLink EDI:    materref   
Fax    07 3163 8548

 

 

 

 

Emergency

If any of the following are present or suspected, phone 000 to arrange immediate transfer to the emergency department or seek emergency medical advice if in a remote region:

 

View list of conditions:

  • Acute stroke/TIA
  • Bilateral limb weakness with or without bladder and/or bowel dysfunction
  • Acute rapidly progressive weakness (Guillain-Barre Syndrome, myelopathy)
  • Acute onset severe:
    • ataxia
    • vertigo
    • visual loss
  • Status epilepticus/epilepsy with red-flags:
    • first seizure
    • focal deficit post-ictally
    • seizure associated with recent trauma
    • persistent severe headache > 1 hour post-ictally
    • seizure with fever
  • Altered level of consciousness
  • Headache with red-flags:
    • 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
    • recent onset headaches in young obese females
  • Delirium/sudden onset confusion with or without fever
  • Acute severe exacerbation of known MS

 

Scope of Service

Conditions out of scope

The following conditions are not routinely provided at Mater Hospital Brisbane:

View list of conditions:

  • 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 (consider neurosurgery)
  • Back and Neck Pain
  • Chronic unexplained pain / pain syndrome

 

Conditions in scope

Headache / Migrane

Essential information (Referral will be declined without this)

  • General Referral Information
  • List all treatments trialed (at least three)
  • ELFT FBC results
  • ESR CRP for patient > 50 years or if giant cell arteritis or vasculitis suspected
  • Medication history, including non-presciption medications, herbs and supplements

Additional referral information (useful for processing the referral)

  • Neuroimaging results (MRI preferable)

Other useful information for management (not an exhaustive list)

  • Chronic/complicated headache/migraine unresponsive to medical management
  • Consider medication overuse headache if patient using large amounts of over-the-counter analgesics such as aspirin, opioids, paracetamol and/or caffeine

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

New onset headache with concerning clinical signs e.g. increasing intracranial pressure; papilledema, blurred vision

Abnormal neurological exam with concerning features on neuroimaging

 

Severe frequent headaches and trial of at least 3 migraine preventers without improvement and/or absent from work or study for more than 4 days per month (List 3 treatments trialled)

 

Chronic/complicated headache/migraine unresponsive to medical management

NB Category 3 cases can be referred to local / regional general physician if neurologist accessis not locally available 

 

Movement Disorders

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral)

  • Detailed history of abnormal movements
  • Accurate neurological exam results
  • Any investigations done to exclude alternative diagnoses e.g. nerve conduction study, EEG, CT Brain and MRI Brain

Other useful information for management (not an exhaustive list)

  • Movement disorders are predominantly a clinical diagnosis therefore a detailed history of the abnormal movements and an accurate neurological examination are vital
  • CT/MRI head
  • Consider chronic disease management plan to access allied health
  • Consider allied health (physiotherapy, occupational therapy, speech therapy) management
  • to assess functional capacity if disability increasing
  • speech pathology for assessment of swallowing and/or communication difficulties
  • occupational therapist and physiotherapist for patients with mobility/ADL changes

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Severe motor or non-motor complications of Parkinson Disease leading to substantial disability

Severe non-Parkinson Disease movement disorder (e.g. new chorea), not explained by pre-existing conditions

 

 

Parkinson Disease

Known or suspected:

  • Tics and Tourette Syndrome
  • Cerebellar related ataxia
  • Dystonia
  • Myoclonus
  • Huntington’s disease

Tardive dyskinesia

Non-progressive movement disorder i.e. essential tremor

 

Peripheral Neuropathy

Essential information (Referral will be declined without this)

  • General Referral Information
  • ELFT FBC fasting BSL ESR CRP TFT B12 folate results
  • ANA/anti-dsDNA results
  • Serum Protein Electrophoresis (SPEP) results
  • Thiamine results
  • Syphilis, Hep B; Hep C; HIV results

Additional referral information (useful for processing the referral)

  • Nerve conduction study
  • Drug and alcohol history 

Other useful information for management (not an exhaustive list)

  • Consider nerve conduction study
  • Only refer for NCS for CTS and ulnar neuropathies having failed 6 months of maximal medical management 
  • If painful neuropathy consider pain relief e.g. amitriptyline or pregabalin
  • Optimise management of:
  • diabetes
  • thyroid disease
  • excessive alcohol intake
  • Consider allied health management

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Rapidly progressive peripheral neuropathy, leading to weakness or disbalance

Severe focal neuropathies or plexopathies of unclear cause

 

 

No category 2 criteria

 

Suspected or diagnosed peripheral neuropathy without severe complications

Mild to moderate neuropathy likely due to known and treated underlying cause (e.g. diabetic neuropathy)

 

Progressive Loss of Neurological Function

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral)

  • ELFT FBC results
  • Nerve conduction studies
  • MRI brain and spinal cord results

Other useful information for management (not an exhaustive list)

  • ELFT FBC
  • Consider nerve conduction studies for suspected MND
  • Consider MRI Brain for suspected MS
  • Consider allied health (physiotherapy, occupational therapy, speech therapy) management
  • to assess functional capacity if disability increasing
  • speech pathology for assessment of swallowing and/or communication difficulties
  • occupational therapist and physiotherapist for patients with mobility/ADL changes
  • Consider chronic disease management plan to access allied health
  • Consider hydrotherapy if mobility compromised

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Rapidly progressive neurological or visual field deficit including weakness, ataxia or cranial nerve deficits (e.g. MS, MND, myasthenia gravis, myositis)

 

Progressive neurological or visual field deficit including weakness, ataxia or cranial nerve deficits (e.g. MS, MND, myasthenia gravis, myositis)

 

Known or suspected slowly progressive or untreatable neurodegenerative illness

 

Seizure / Epilepsy

Essential information (Referral will be declined without this)

  • General Referral Information
  • ELFT FBC drug level results
  • History of seizures
  • Medication history, including non-prescription medications, herbs and supplements

Additional referral information (useful for processing the referral)

  • EEG results
  • Neuroimaging results
  • Drug level results
  • Family history 
  • Drug and alcohol history 
  • Sleep studies
  • HIV, syphillis results

Other useful information for management (not an exhaustive list)

  • Ensure compliance, consider drug levels
  • Optimise current drug therapy/consider increasing dose if already on medication
  • Exclude drug interactions e.g. concurrent cytochrome inducers, binding agents
  • Reconsider diagnosis if no response to medication
  • Treat any inter-current infections and co-morbidities
  • Address any lifestyle issues e.g. adequate sleep, stress, alcohol, recreational drugs
  • Neuroimaging to rule out space occupying lesion or intracranial pathology
  • EEG

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

New diagnosis of epilepsy (confirmed or highly likely)

First epileptic seizure (as convulsive syncope is a common mimic, may be seen by general medicine prior to neurology, depending on local pathways)

Frequent seizure activity without current anticonvulsants use

Pregnancy in a patient with known  epilepsy

 

Poorly controlled epilepsy (e.g. increased frequency of seizures, change in seizure activity) in patient with good adherence to medical treatment. (This may be categorised as Cat 1 depending on severity)

 

Chronic epilepsy without concerning features

Epilepsy advice and management plan including driving recommendations and decreasing anti-epileptic medication

NB Category 3 cases can be referral to local / regional general physican if neurologist access is not locally available

 

Stroke / Transient Ischaemic Attack (TIA)

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral)

  • ABCD2 stroke risk score
  • ECG results
  • Doppler ultrasound carotid vessels
  • Echocardiogram, if indicated e.g. arrhythmia, cardiac murmurs, heart failure
  • Holter monitor results

Other useful information for management (not an exhaustive list)

  • Antiplatelet and statin therapy
  • Consider anticoagulation therapy if appropriate
  • Risk factor assessment/modification (hypertension diabetes, smoking)
  • Consider referral to speech pathology if swallowing or communication deficits evident

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Refer directly to emergency if clinically indicated:

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

Stroke/TIA known or suspected with last change in symptoms less than 2 weeks prior to referral

 

Stroke/TIA known or suspected with last change in symptoms more than 2 weeks prior to referral

Chronic ischaemic lesion identified on imaging not previously addressed

 

 

Other Neurology Condition

Essential information (Referral will be declined without this)

  • General Referral Information
  • Relevant condition information
  • Presence and duration of neurological signs and symptoms
  • Relevant pathology and imaging reports

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

 

Our Specialists 

Dr Stefan Blum

Neurologist

Dr Sasha Dionisio

Neurologist

Dr Lisa Gillander

Neurologist

Dr Alexander Lehn

Neurologist

Dr Daniel Schweitzer

Neurologist


Bulk Billed Clinics 

Mater Health offers patients the opportunity to attend bulk billed clinics. To provide your patient with the opportunity to attend a bulk billed clinic, please provide a named referral to one of the specialists listed above.

Contact Us 

If you would like to discuss a referral, including clinical criteria, or update the status of a current patient please contact our priority GP phone line on 07 3163 2200 

 Current Waiting Time for Appointments 

We provide up to date data on how long patients are waiting for their first appointment by specialty here.

Referral Guideline Development

These Mater Referral Guidelines align with standardised best practice tools for referral to publicly funded specialist outpatient services developed in Queensland through the Clinical Prioritisation Criteria project.

 

Content last reviewed: 15 February 2018

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