Seizures/ epilepsy

Out of scope / wrong door

Adult - 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 include post-concussion injury - Radiculopathy or chronic back pain, see specific Spine CPC - Chronic unexplained pain/ pain syndrome - Falls (refer to General Medicine CPC or Geriatrics first) [https://www.health.qld.gov.au/cpc/general-medicine/falls] - Dizziness (To General Medicine first) [https://www.health.qld.gov.au/cpc/general-medicine/states-of-altered-neurological-function] - Stroke rehabilitation (To Rehabilitation) - Functional disorders that do not resemble Neurological conditions” e.g. functional blindness - Concussion - Simple febrile seizures in a developmentally normal child with no risk factors for epilepsy (e.g. no known brain abnormality) - New onset epileptic seizures in a developmentally normal child > 2 years of age (unless specific criteria for - Neurology referral – see Epilepsy/Seizures CPC’s) - Syncope with stiffening/twitching during the syncopal event (convulsive syncope) - Head injury including concussion (consider neurosurgery and rehabilitation services) - Tics and Tourette syndrome - ADHD - Autism spectrum disorders, unless concern for epileptic encephalopathy or regression - Mild global developmental delay - Headache (unless specific criteria for Neurology referral – see Headache/Migraine CPC’s) - Toe walking without fixed foot deformity, - Cerebral palsy (Paediatrician and Rehabilitation services can refer to Neurology for support with aetiological diagnosis if required) - Stereotypic movements (primary or complex motor stereotypies) – differentiating from epilepsy in a young child can be supported by Neurologist review of videos - Dizziness and vertigo (unless paroxysmal in nature and concern for an epileptic basis) - Idiopathic intracranial hypertension (unless specific criteria for Neurology referral – see Headache/Migraine CPC’s) - Functional neurological symptom disorder (unless specific criteria for Neurology referral – see Functional Neurological Symptoms CPC’s) - Bell’s palsy - Erb’s/Klumpke’s palsy - Horner’s syndrome - Arterio-venous malformation, Vein of Galen malformations, Arterio-Venous fistulas and aneurysms (consider neurosurgery) - Haematological disorders with no previous stroke but concern regarding increased risk of stroke (consider Haematology referral) - Incidental findings on MRI brain scans considered of no clinical significance for the patient now or into the future, specifically static T2/FLAIR hyperintensities in white matter (‘unidentified bright objects’) and pineal cysts. Approximately 18% of MRIs in healthy volunteers show incidental findings, of these 15/18% required no referral. Of incidental findings that require referral, the majority are neurosurgical conditions (tumor, arachnoid cyst, vascular abnormalities such as cavernous angioma). Progressive demyelinating disorders (multiple sclerosis) are rare in childhood, if this condition is considered, call the on-call Neurology service (after transfer of images to Queensland Health PACS system so they are available for case discussion) Paediatric