Peripheral neuropathy

Emergency and immediate referrals

Referral to Emergency Department

If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergent medical advice if in a remote region:

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

Immediately contact on-call registrar or service to arrange an immediate neurology assessment (seen within 7 days) for:

To contact the relevant service, please see HealthPathways: Acute Neurology Assessment

Presenting issues
Suspected peripheral neuropathy Progressive neuropathy of uncertain cause

Mandatory referral information (referral will be returned if this information is not included)
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 If unable to attach reports, please include relevant information/findings in the body of the referral Referrer to state reason if not able to include mandatory information in referral (e.g. patient unable to access test due to geographical location or financial cost)

Mandatory referral information (referral will be returned if this information is not included)

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

If unable to attach reports, please include relevant information/findings in the body of the referral

Referrer to state reason if not able to include mandatory information in referral (e.g. patient unable to access test due to geographical location or financial cost)

Highly desirable referral information
Any previous EMG reports Any physiotherapy assessment results

Indicative triage category

Indicative triage 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)

Last reviewed: 29-06-2023

Peripheral neuropathy

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