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Minimum Referral Criteria

  • Category 1
    (appointment within 30 calendar days)
    • Recurrent hemiplegic migraine
    • 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)
    • Idiopathic intracranial hypertension referred by a Paediatrician where there is diagnostic uncertainty that headache is due to IIH, failure of response to treatment and no visual impairment on perimetry (no indication for urgent neurosurgical shunting).
    • Migraine that has failed two (2) preventative medications
    • Missing significant amounts of school due to headaches
    • Suspicion of medication overuse
  • 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

  • Detailed history of headaches
    • how long has the patient been getting headaches?
    • what is their frequency and duration?
    • is the child missing school (how many days per month) or is normal daily activity limited?
    • is there associated symptoms (vomiting, light/sound sensitivity)?
  • BP (right arm, with appropriately sized cuff)
  • Current medication history, efficacy (including over-the-counter preparations)
  • Neurological examination including fundoscopy
  • Confirmation of OOHC (where appropriate)

3. Additional referral information Useful for processing the referral

Highly desirable Information – may change triage category

  • Exacerbating and relieving factors
  • Reason for presentation currently
  • Details of previous specialist assessment
  • Headache diary
  • 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.

  • Other past medical history
  • Immunisation history
  • Developmental history
  • Significant psychosocial risk factors (especially parents mental health, family violence, housing and financial stress, department of child safety involvement)
  • Height/weight/head circumference and growth charts with prior measurements if available.
  • Other physical examination findings inclusive of CNS, birth marks or dysmorphology
  • Any relevant laboratory results or medical imaging reports, urinalysis result
    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: 21 June 2023