Neurology

Emergency conditions/symptoms include (not an exhaustive list):

• Thunderclap headache
• Possible meningoencephalitis: fever, neck flexion stiffness, rash
• First headache with focal neurological signs or symptoms (consider stroke)
• Persistent altered or worsening mental state in the post-ictal period
• First seizure with fever
• Seizure with recent trauma
• Persistent severe headache over one hour post seizure
• Status epilepticus; single prolonged seizure (over five minutes) or recurrent seizures without regaining consciousness between seizures
• Epileptic patient vomiting or too unwell to take medication
• Epilepsy with significant fever
• Symptoms or signs suggestive of a posterior circulation TIA or stroke (cranial nerve signs, vertigo, diplopia, nausea etc.)
• Rapidly progressive weakness +/- other symptoms/signs suggestive of Guillain–Barré syndrome

Suspected TIA's will not be seen in general Neurology Clinic or Stroke Clinic.

Many established neurological diagnosis or problems are to be seen in subspecialty clinics:

• Multiple Sclerosis
• Transient Ischemic Attack (TIA): patients can only be booked into this clinic following discussion with the Stroke Registrar or on-call Neurologist; suspected TIA's will not be seen in general Neurology Clinic or Stroke Clinic
• Epilepsy: complex and chronic epilepsy.  Routine epilepsy and first seizures should attend general Neurology Clinic
• Movement disorders including Parkinson's Disease
• General geriatrics for possible dementia or fall

eReferral is now the preferred method of referral for this service and is available in All regions. Please refer via HealthLink SmartForm eReferral through your software system (either Best Practice, or Medical Director). For instructions, see the creating an eReferral quick guide.

The RHH Neurology Clinic is always heavily booked. The wait time for RHH General Medical Clinics is much shorter. Please consider referral to RHH General Medicine for problems that do not have clear neurological basis, include unconscious collapse, and non-specific neurological symptoms in the absence of seizure.

Isolated back pain should be referred to the Back Assessment Clinic via Rheumatology eRegerral.

For chronic pain consider the RHH Persistent Pain Clinic.

Neurophysiological testing requires a separate referral.  If you also require a clinic consultation with a neurologist, please complete two separate referrals:

• Neurophysiology referrals: NCS/EMG/EEG can be submitted via HealthLink Smart Form eReferral or sent to the Neurology Department Fax: 03 6173 0292
• No formal clinical opinion will be provided during the NCS/EMG session
• Neurologist referrals are sent to the Outpatient Clinic Fax: 03 6173 0491

Launceston General Hospital Neurology Clinic - Launceston General Hospital now has a full suite of neurologists and can accept urgent, semi-urgent and non-urgent referrals, including referrals from the North West. Launceston General Hospital specialists' areas of interest include Spasticity, Movement Disorders, Stroke, General Neurology, Multiple Sclerosis, EMG and Epilepsy.

All referrals are triaged and allocated according to clinical guidelines as urgent or non-urgent. A written referral stated urgent does not guarantee urgent attention.

Appointments are based on clinical priority.

Urgent (Category 1)

We will endeavour to see these patients within two weeks.

Urgent referrals should be accompanied by a phone call, as per below:

• Contact the Neurology Registrar directly within hours via the Royal Hobart Hospital switchboard Phone: 03 6166 8308

Routine (Category 3)

Next available appointment.