Peripheral Neuropathy

Availability

North South North West Statewide

Pre-referral work-up

History

  • Onset of symptoms and progression, location, pain, associated weakness
  • Co morbidities:
    • Endocrine conditions such as thyroid disease or diabetes
    • Systemic symptoms or known conditions
    • Medications including illicit drugs and alcohol
  • Recent upper respiratory tract infection or gastrointestinal illness (in cases of acute neuropathy)

Tests

  • Nerve conduction studies
  • Peripheral neuropathy screening bloods:
    • FBE
    • BSL
    • ESR
    • LFT
    • UEC
    • Vit B12
    • Folate
    • Serum protein electrophoresis
    • Urine Bence Jones protein

Interim/GP management

To refer a patient with this condition, please see the Neurology clinic page for the full referral process and templates.

Management of co-morbidities.

Nerve conduction studies may provide an answer your clinical question without need for a neurologists clinical opinion.

Consider trial of neuropathic pain medication if pain is a significant issue such as amitriptyline or pregabalin.

Direct link to Health Pathways - Peripheral Neuropathy page

For more information please see the Tasmanian Health Pathways website.

Emergency

Rapidly progressive weakness +/- other symptoms/signs suggestive of Guillain–Barré syndrome

Urgent / category 1

Subacute weakness and sensory disturbance over weeks-months

Routine / category 3

Longstanding symptoms

Red flags are clinical indicators of possible serious underlying conditions requiring further medical intervention. They may or may not indicate an emergency.

If you require a neurophysiological test and a clinic consultation, please complete two separate referrals and send the one for NCS/EMG to the Neurology Department Fax: (03) 6173 0292 and the OPD referral to the Clinic Fax:  6234 3982. 

No formal clinical opinion will be provided during the NCS/EMG session.

Emergency:

Proceed to Emergency Department (ED).
LGH ED Reception  – Phone: (03) 6777 6405  Fax: (03) 6777 5201
MCH ED* – Phone: (03) 6478 5120  Fax: (03) 6441 5923
NWRH ED* – Phone: (03) 6493 6351 Fax: (03) 6464 1926
RHH ED Reception – Phone: (03) 6166 6100  Fax: (03) 6173 0489

Advice for medical practitioners can be given by the Medical Officer In Charge (MOIC) - see HealthPathways Tasmania for contact information.
*MCH and NWRH MOICs request GPs call them prior to referring a patient to ensure the patient is being sent appropriately to a safe destination.

Urgent:

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 RHH switchboard Phone: (03) 6166 8308
Semi-urgent:
Routine:

Next available appointment