Referral guideline – Abnormal movements, tics or unsteadiness

Introduction

These are neurologic syndromes in which there is either an excess of movement or a paucity of voluntary and automatic movements, unrelated to weakness or spasticity.

GP management

  • Neurological examination including fundoscopy
  • Video of suspected abnormal movement

When to refer

Consider referral to the nearest emergency department that treats children if an acutely unwell patient presents with the following:

  • other neurological symptoms
  • prodromal illness
  • regression of developmental milestones
  • abnormal neurological examination
  • well children should be referred to the nearest general paediatric service in the first instance
  • general paediatricians should consider referral to LCCH neurosciences following failure of first line treatment (e.g. child psychology and/or medications).

Essential referral info

  • Detailed history of the movements (nature, severity, onset, associated symptoms etc.)
  • Presence of any concerning features
  • Patient details
  • Medicare number
  • Parent/carer name and contact details
  • Referring clinician details (name, contact details, provider number, date and length of referral)

Helpful referral info

  • Examination findings including fundoscopy
  • Height/weight/head circumference
  • Birth and developmental history
  • Any relevant laboratory tests
  • Medication history (including OTC)
  • Significant psychosocial risk factors

Parent service

Neurosciences

Contact details

Hospital Switchboard
(Ask for the General Paediatric Registrar)
t: 07 3068 1111

Resources

Movement Disorders in Children