Peripheral neuropathy Referral Access Criteria

Referrers should use this page when referring patients to public adult neurology outpatient services for peripheral neuropathy.

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 onset or rapid progression (over hours or days) motor impairment with functional loss

Immediate referral
Immediately contact on-call registrar or service to arrange immediate neurological assessment (seen within 7 days):
Nil To contact the relevant service, see Clinician Assist WA: Acute Neurology Assessment (external site)

Clinical indications for outpatient referral
If any of these issues are present, refer to outpatient services through the Central Referral Service (CRS).
Suspected peripheral neuropathy Progressive neuropathy of uncertain cause

Mandatory information
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.
History	Relevant history, onset and duration of symptoms including: Anatomical site and which limbs are involved Details of any pain or weakness Evolution of symptoms – new onset, progressive, stable or improving Degree of functional impairment (e.g. impact on mobility/falls/employment/ADLs/weight loss/carer information) Alcohol intake Relevant past medical history e.g. diabetes Indicate whether the patient has previously attended a neurology clinic or seen a neurologist, or any other specialist doctor (e.g. geriatrician, physiotherapist, ENT specialist, vestibular physiotherapist, ophthalmologist) If so, please attach contact details, dates and any other information and correspondence relating to these visits
Examination	Physical examination findings including motor and sensory signs, reflexes in limbs, gait
Investigations	Vitamin B12 Thyroid SLE Diabetes

Highly desirable
History	Any previous EMG reports
Examination	Nil
Investigations	Any physiotherapy assessment results

Indicative clinical urgency category
Category 1 Appointment within 30 days	Rapidly evolving (over weeks) neuropathy of uncertain cause, with significant impact to function (e.g. falls risk)
Category 2 Appointment within 90 days	Progressive motor neuropathy with impact on function, gait and balance
Category 3 Appointment within 365 days	Suspected or diagnosed peripheral neuropathy without severe complications Mild to moderate neuropathy likely due to known and treated underlying cause (e.g. diabetic neuropathy)

Indicative clinical urgency category

Category 1

Appointment within 30 days

Rapidly evolving (over weeks) neuropathy of uncertain cause, with significant impact to function (e.g. falls risk)

Category 2

Appointment within 90 days

Category 3

Appointment within 365 days

Suspected or diagnosed peripheral neuropathy without severe complications
Mild to moderate neuropathy likely due to known and treated underlying cause (e.g. diabetic neuropathy)

Exclusions
Nil

Useful information
Nil

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Last reviewed: 29-06-2023

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