Clinical Lead - Dr Andrew Swayne
Catchment criteria applies for referrals for this service. Patient referrals from outside the Mater SEQ Catchment (which includes Metro South and West Moreton Hospital and Health Services) may not be accepted.
This page contains information for general practitioners on how to refer patients aged 16 years and over to Neurology services at Mater Hospital Brisbane.
Mater offers a comprehensive neurology service for public patients through the Mater Neurosciences Centre Brisbane. Consisting of surgeons, physicians, nurses and allied health professionals, the Mater Neurosciences Centre Brisbane 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
- Mater Advanced Epilepsy Unit - requires a neurologist referral
- Mater Memory and Cognitive Disorders 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 a close relative or friend attends your appointment with you.
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.
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
Bulk Billed Clinics
Mater Health Services offers patients the opportunity to attend bulk billed clinics. To provide your patient with the opportunity to attend a bulk billed specialist clinic, please provide a named referral to one of our specialists listed above.
Current Waiting Time for Appointments
We provide up to date data on how long patients are waiting for their first appointment by specialty here.
Emergency care
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:
Emergency conditions
Stroke/transient ischaemic attack (TIA)
- Patient with acute neurological symptoms of a stroke; multiple/crescendo TIA
- New acute symptoms
Progressive loss of neurological function
- Acute onset severe:
- ataxia
- vertigo
- visual loss
- Acute severe exacerbation of known MS
- Acute myopathy, severe myasthenia exacerbation, GBS
Seizures/epilepsy
- Status epilepticus/epilepsy with concerning features:
- first seizure
- focal deficit post-ictally
- seizure associated with recent trauma
- persistent severe headache > 1 hour post-ictally
- seizure with fever
Headache/migraine
- Headache with concerning features:
- 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
- headaches with papilledema
- >50 years with raised CRP/ESR or if giant cell arteritis or vasculitis suspected
Movement disorders
- Sudden onset of severe, disabling movement disorder
Peripheral Neuropathy
- Rapid (<2 weeks) progressive neuropathy where Guillain-Barre is suspected
- Sub-acute painful neuropathy where systemic vasculitis is suspected
Other referrals to emergency
- Altered level of consciousness
- Bilateral limb weakness with or without bladder and/or bowel dysfunction
- Acute rapidly progressive weakness (Guillain-Barre Syndrome, myelopathy)
- Delirium/sudden onset confusion with or without fever
Conditions in scope
Headache / Migraine
Essential information (Referral will be declined without this)
- General Referral Information
- List all treatments trialed (at least three) and reasons for failure
- Medication history, including non-prescription medications, herbs and supplements
Additional referral information (useful for processing the referral)
- Neuroimaging results (MRI preferable)
- ELFT, FBC, ESR, CRP results
- ECG Tracing
Other useful information for management (not an exhaustive list)
- Refer to Healthpathways or local guidelines
Medical Management:
- Manage migraine-acute pain treatment, dietary advice, hormone management and or preventative medications trail for at least 2-3 months
- Tension/cervicogenic headaches- simple analgesia, massage, physiotherapy review
- Consider ELFT FBC ESR CRP in patients at risk for a systemic cause for headaches
- Consider medication overuse headache if patient using large amounts of over-the-counter analgesics such as aspirin, opioids, paracetamol and/or caffeine
- Consider neuroimaging to exclude intracranial pathology
- Social modifiers - impact to ADLs
- Adequate chronic disease/lifestyle (SNAP) management is a requirement for most patients
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 frequent headaches and trial of at least 3 migraine preventers without improvement (List 3 treatments trialed)
| Chronic/complicated headache/migraine unresponsive to medical management |
Movement Disorders
Essential information (Referral will be declined without this)
- General Referral Information
- TSH results for tremors
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
- ELFTs
Other useful information for management (not an exhaustive list)
- Refer to Health pathways or local guidelines.
- Movement disorders are predominantly a clinical diagnosis therefore a detailed history of the abnormal movements and an accurate neurological examination are vital.
- 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 symptoms or abrupt onset/deterioration of movement disorder
| Known or suspected:
| Non-progressive movement disorder i.e. essential tremor |
Peripheral Neuropathy
Essential information (Referral will be declined without this)
- General Referral Information
- FBC fasting BSL ESR CRP TFT B12 folate results
- ANA
- Chem20, Light chains, Serum Protein Electrophoresis (SPEP) with immunofixation results
- Serum Protein Electrophoresis (SPEP) results
- History of diabetes or chemotherapy
Additional referral information (useful for processing the referral)
- ELFT, CRP, TFT,
- Thiamine results
- Syphilis, Hep B; Hep C; HIV results
- Nerve conduction study
- Drug and alcohol history
Other useful information for management (not an exhaustive list)
- Refer to Healthpathways ot local guidelines
- If painful neuropathy consider pain relief e.g. amitriptyline or pregabalin
- Optimise management of:
- diabetes
- 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 |
Rapid progression of sensory or motor deficits attributable to peripheral nerve involvement over <4 weeks, OR onset of severe painful neuropathy in last 3 months Recent onset painful neuropathy
| Progressive motor neuropathy with impact on gait and balance Progressive neuropathy of uncertain cause | 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)
- General Referral Information
- Detailed history of presenting complaint and timeline of the symptoms and deterioration
Additional referral information (useful for processing the referral)
- ELFT FBC results
- Lumbar results
- Nerve conduction studies
- History of consultation with other specialist/allied health or discharge summary
- MRI brain and spinal cord results
Other useful information for management (not an exhaustive list)
- Refer to Healthpathways or local guidelines
- All rapid visual loss to see ophthalmology first
- 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 |
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)
| Chronic or slowly deteriorating neurodegenerative illness |
Seizure / Epilepsy
Essential information (Referral will be declined without this)
- General Referral Information
- History of seizures
- Medication history, including non-prescription medications, herbs and supplements
- Management history of epilepsy (including previous medication, dosage, efficacy, side effects)
Additional referral information (useful for processing the referral)
- ELFT FBC
- EEG results
- Neuroimaging results
- Family history
- Drug and alcohol history
- Sleep studies
- HIV, syphilis results
Other useful information for management (not an exhaustive list)
- Refer to Healthpathways or local guidelines
- Ensure compliance, consider drug levels if non-compliance is suspected
- 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
- Adequate chronic disease/lifestyle (SNAP) management is a requirement for most surgical procedures
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) without a review by neurologist First epileptic seizure (as convulsive syncope is a common mimic, may be seen by general medicine prior to neurology, depending on local pathways) Frequent epileptic seizure activity without current use of antiseizure medications Documented increased frequency of Generalised tonic-clonic or bilateral tonic-clonic seizures in patient with good adherence to medical treatment 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) Psychogenic non-epileptic seizures (PNES) /Suspected dissociative attacks* seeking clarification of diagnosis *Suspected dissociative seizures should be triaged according to the social and medical impact of their epileptic-seizure counterparts rather than based on the (suspected) cause
| Chronic epilepsy without concerning features
Epilepsy advice and management plan including driving recommendations and decreasing anti-epileptic medication |
Stroke / Transient Ischaemic Attack (TIA)
Essential information (Referral will be declined without this)
- General Referral Information
- Medication list
- Neuroimaging results
- Relevant previous medical history
Additional referral information (useful for processing the referral)
- ELFT, FBC, fasting lipids and glucose results
- ABCD2 stroke risk score
- ECG results
- Doppler ultrasound carotid vessels
- Echocardiogram
- Holter monitor results
- Discharge summary (if the patient is being referred for second opinion)
Other useful information for management (not an exhaustive list)
- Refer to Healthpathways or local guidelines
- 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
If the question relates to resumption of pre-stroke activities e.g. driving or working, please also refer to and include the Rehabilitation discharge summary.
Consider driving advice
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 |
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 Covert brain infarction – and other neurovascular “what is this lesion” questions i.e., ICAD, DVAs, suspected amyloid angiopathy changes
|
Suspected Idiopathic intracranial hypertension (IIH)
Essential information (Referral will be declined without this)
- General Referral Information
- Medication history, including non-prescription medications, herbs and supplements
Additional referral information (useful for processing the referral)
- ELFT FBC ESR CRP results
- MRI Report (for processing the referral)
Other useful information for management (not an exhaustive list)
- Optometrist / ophthalmology review, including computerized visual fields and OCT
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 |
Suspected IIH with visual symptoms or severe headaches
| Headache or pulsatile tinnitus with MRI reported soft signs of IIH without papilloedema | Suspected IIH without symptoms or MRI findings suggestive of IIH |
Conditions not in scope
Non-routine 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)
- Chronic unexplained pain / pain syndrome
- Falls (refer to General Medicine CPC or Geriatrics first)
- Dizziness (to General Medicine first)
- Stroke rehabilitation (to Rehabilitation)
- Functional disorders that do not resemble Neurological conditions e.g. functional blindness
- Concussion