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Functional neurological symptoms


Minimum Referral Criteria

  • Category 1
    (appointment within 30 calendar days)
    • Unable to attend school or other significant disability due to symptoms
    • High levels of health anxiety (e.g. patient's condition mimics stroke/epilepsy/neuropathy)
    • A child currently in out of home care (OOHC), or at risk of entering or leaving OOHC, where they have previously been on a waiting list for this problem and were removed without receiving a service.

  • Category 2
    (appointment within 90 calendar days)
    • Patients with FNS without the level of disability required for cat 1, referred by a General Paediatrician
    • Request for second opinion for diagnosis
  • Category 3
    (appointment within 365 calendar days)
    • No category 3 criteria

1. Reason for request Indicate on the referral

  • To establish a diagnosis
  • For treatment or intervention
  • For advice and management
  • For specialist to take over management
  • Reassurance for GP/second opinion
  • For a specified test/investigation the GP can't order, or the patient can't afford or access
  • Reassurance for the patient/family
  • For other reason (e.g. rapidly accelerating disease progression)
  • Clinical judgement indicates a referral for specialist review is necessary

2. Essential referral information Referral will be returned without this

  • Description of symptom(s) including date of onset, nature of the symptoms, duration and frequency (eyewitness history where possible)
  • Burden of disease information:
    • is the child missing school? How many days missed in the last month?
  • Confirmation of OOHC (where appropriate)

3. Additional referral information Useful for processing the referral

Highly desirable Information – may change triage category

  • Note if there are triggers or associations with the events or not. For example, pain, frustration, exercise, feeding, sleep.
  • If the child is in foster care, please provide the name and regional office for the Child Safety Officer who is the responsible case manager.

    Desirable information- will assist at consultation

  • Any allied health assessments
  • Other past medical history
  • Immunisation history
  • Developmental history
  • Medication history
  • Significant psychosocial risk factors (especially parents mental health, family violence, housing and financial stress, department of child safety involvement)
  • Examination findings inclusive of CNS, birth marks or dysmorphology

    Investigation results:

  • ECG, EEG and neuroimaging if available. (Do not order these tests for the referral if they are not clinically required)
  • If neuroimaging has been done, arrange image transfer to PACS at the hospital the patient is being referred to, with the imaging reports. If electronic imaging transfer is not available, then a CD of the neuroimaging and report should be sent to the neurologist named in the referral.

4. Request

Last updated: 13 June 2023