Table 3

Clinical pointers to consider referral to a specialist in neurodisability or neurology

Features in the historyRegression or possible regression including significant change in behaviour
Possible or definite seizures
Movement disorder: continuous or paroxysmal
Muscle pain/fatigue
New onset sensory impairment, for example, significant decline in visual acuity
Cognitive decline/behavioural change in a child with epilepsy or ASD
Examination findingsNeurological signs: dystonia, ataxia, movement disorder, for example, chorea, focal signs, cranial nerve signs, muscle weakness/signs of a peripheral neuropathy, arthrogryposis/joint contractures, CP picture without a clear cause/history
Ocular signs: nystagmus, eye movement disorder, abnormal fundi, cataract
Other signs: sensorineural deafness
Neurocutaneous features
Organomegaly/cardiomegaly
Course or dysmorphic facial features
  • CP, cerebral palsy.