Progressive loss of neurological function Referral Access Criteria
Progressive loss of neurological function Referral Access Criteria
| Referrers should use this page when referring patients to public adult neurology outpatient services for progressive loss of neurological function. |
| Emergency referral |
 If any of the following are present or suspected, refer the patient to the emergency department or seek emergency medical advice if in a remote region. |
- Acute severe exacerbation of known MS
- Acute rapidly progressive weakness (Guillain-Barre Syndrome, myasthenia gravis, myelopathy)
- Bilateral leg weakness with or without bladder and/or bowel dysfunction
- Acute onset severe progressive ataxia, vertigo and/or visual loss
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| Immediate referral |
 Immediately contact on-call registrar or service to arrange immediate neurological assessment (seen within 7 days):
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To contact the relevant service, see Clinician Assist WA: Acute Neurology Assessment (external site)
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| Clinical indications for outpatient referral |
If any of these issues are present, refer to outpatient services through the Central Referral Service (CRS).
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- Progressive loss of neurological function
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| Mandatory information |
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Referrals missing 'mandatory information' with no explanation provided may not be accepted by site. If 'mandatory information' is not included, the explanation must be provided in the body of the referral (e.g. patient unable to access test in regional or remote areas or due to financial reason).
This information is required to inform accurate and timely triage. If unable to attach reports, please include relevant information/findings in the body of the referral and advise where (provider) investigation/imaging was completed.
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| History |
- Relevant history, onset and duration of symptoms including:
- Evolution of symptoms – progressive, stable or improving
- State which neurological symptom/dysfunction is progressing e.g. weakness, ataxia, diplopia, oropharyngeal dysphagia, visual field cognition
- State onset, speed of progress and what function(s) is affected
- Degree of functional impairment (e.g. impact on mobility/falls/employment/ADLs/weight loss/carer information)
- Relevant medical history
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| Examination |
- Physical examination findings including:
- Visual fields
- Full neurological examination
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| Investigations |
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| Highly desirable |
| History |
- Indicate whether the patient has previously attended a neurology clinic or seen a neurologist, or any other specialist doctor e.g. urologist
- If so please attach contact details, dates and any other information and correspondence relating to these visits.
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| Examination |
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| Investigations |
- CK
- TFTs
- Vitamin B12
- Acetylocholine Receptor Antibodies
- EMG/NCS
- MRI neuraxis (brain/spinal cord)
- Cognitive scores
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| Indicative clinical urgency category |
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Category 1
Appointment within 30 days
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- Rapidly progressive neurological or visual field deficit including weakness, ataxia or cranial nerve deficits (e.g. MS, MND, myositis)
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Category 2
Appointment within 90 days
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Progressive neurological or visual field deficit including weakness, ataxia or cranial nerve deficits (e.g. MS, MND, myasthenia gravis, myositis)
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Category 3
Appointment within 365 days
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- Chronic or slowly deteriorating neurodegenerative illness
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Last reviewed: 29-06-2023