Neurology Service at John Hunter Children's Hospital

The Paediatric Neurology Unit at John Hunter Children's Hospital is one of three such units in NSW. The facility services a wide referral area from several larger regional centres to many smaller rural and remote centres for children in northern NSW outside Sydney.

The Paediatric Neurology Unit at John Hunter Children's Hospital provides specialist consultation services, diagnostic services, medical treatment, and follow-up care to infants, children, and adolescents who have suspected or confirmed neurological disorders.

What does a Paediatric Neurologist do and specialise in?

Paediatric neurologists combine the expertise in diagnosing and treating disorders of the nervous system (brain, spinal cord, muscles, nerves) with an understanding of childhood medical conditions and the special needs of the child and their family. In many cases, they work as a team with paediatricians and other paediatric specialists when it comes to care for children with more complex or serious medical issues.

The nervous system is a complex, sophisticated system that regulates and coordinates the body's basic functions and activities. It is made up of two major divisions, including the central nervous system (consisting of the brain and spinal cord) and the peripheral nervous system (consisting of all other neural elements). The neurological condition/s may present at any time from birth there on. In fact some conditions make their presence felt even before the newborn is born. The varieties of conditions are different to adult presentations and hence they need special assessments. Some of the conditions are specific to the paediatric population.

Who will be responsible for my child's care and what should we expect?

The Paediatric Neurology Unit has 3 Neurologists who share the clinical workload. The clinical service is supported by one Clinical Nurse Consultant (or Neurology Nurse), a Paediatric trainee rotating every 6 months in Neurology and administrative staff for the unit.

How do you make an appointment?

The standard pathway for a referral to our specialist service begins with a referral letter faxed to the paediatric outpatient department service. Once retrieved, one of the three neurologists will triage them for the best outcome depending on the urgency, escalation and magnitude of the presenting problem. Both the clinical and diagnostic services have waiting times for appointments and the unit strives to best prioritise the referrals. As referrals merit, they are stratified accordingly and the waiting time for clinic appointment varies from being seen as soon as possible to standard wait list periods.

The process is initiated by a referral from the Local Medical Officer or your general practitioner on grounds of a diagnosed or suspected neurological condition. The preferred pathway is an assessment by a Paediatrician that provides an opportunity for a preliminary assessment. A faxed written referral is a must to initiate the process.

Services

A Paediatric client with suspected or diagnosed neurological condition may need assessment and management in one of these different settings:

1. Specialist Neurology Clinics (JHCH)

Most of our clients are seen in the clinic setting with only a small proportion that needs hospital admission for diagnosis or treatment. Parents and carers are encouraged to bring all medical information available at hand for the clinic visit. Parents may bring written information about the medical diagnosis in question, list of symptom(s), past medical history that may include pertinent information related to birth, early development, surgery or procedures and medical information about previous illnesses, 

Appointments are made on referral from your medical general practitioner (LMO) or your Paediatric specialist.

During the consultation: The consultation aims to gather and collate all information relevant to the referral, provide a neurological assessment and order investigations relevant to the referral. It also provides opportunity to discuss various issues around the diagnosis, personal concerns and information that they may have come across from various sources.

2. Inpatient consultation service in the Paediatric Wards (H1, J1, J2 wards), Emergency, Intensive and Neonatal Units

3. Day stay services (JHCH)

This service is applicable to very selective clients based on the investigation or treatment needs. This includes consultation or review on a weekly or as appropriate for those with complex needs; and/or organising admission for sedation procedures such as MRI Imaging, Lumbar puncture or EEG studies.

4. Diagnostic services

a. Electroencephalography (EEG examination)

The EEG examination is simply a study of brain wave patterns. These patterns are normally existing and very specific to individual age groups. In addition to recognising normal brain wave patterns, the emphasis on the electroencephalographer is to look for and screen for abnormal patterns that when put together with clinical information leads to a diagnosis or formulation of epilepsy patterns or syndromes. They are also useful in situations to exclude a possibility of seizure or epilepsy in a first event or recurring events.

Children as young as 3-4 years of age have been successful in cooperating for the procedure. It is painless, takes 15 minutes to set up and is recorded on a computer application for 20-30 minutes. Patient preparation is important and our technologists call to advise before the appointment on sleep deprivation, nap with bottle and in very selective situations sedative medication to calm the child for the procedure to complete successfully.

The results are usually communicated to the referring doctor.

Routine EEG FAQ's
For information regarding a routine EEG please click here.

What is an EEG?
What does the EEG show?
Does an abnormal EEG confirm epilepsy?
How does the EEG help?
What happens before the EEG?
What happens during the EEG?
How long will it take?
Obtaining the results of the test
Some questions that your child might ask about an EEG

b. Clinical neurophysiology that includes nerve conduction/ EMG studies

c. Diagnostic imaging: MRI Imaging, CT Imaging, Ultrasound imaging

MRI procedure is the most common one performed.

Magnetic Resonance Imaging (MRI) FAQ's:
Click here for information on MRI's
 
Is MRI safe?
What is involved with an MRI scan?
Is MRI painful or uncomfortable?
Can I be with my child during the MRI scan?
Are there any special precautions?
Does my child need to fast?
Where do I go and how long will it take?
What if my child is sick or I am unable to keep the appointment?
When will I receive the result?
Mock MRI Scanner
MRI Images
MRI Links

d. CSF- Lumbar puncture. Information about the procedure can be accessed by clicking here.

e. Diagnostic procedure including muscle or skin biopsy.

Contact Us

John Hunter Children's Hospital Administration
8.00am - 4.30pm Monday to Friday
Ph: (02)49 213670

Outside these hours please contact John Hunter Hospital Switch on (02)49 213000