Complex Tone Clinic

The Complex Tone Clinic at CRC offers a National consultancy service for children and adolescents under the age of sixteen with complex spasticity and dystonia. This clinic focuses on the child’s comfort and care needs through Paediatrician-led multidisciplinary consultations. Treatment approaches include, alternative oral medication, Intrathecal Baclofen Pump Therapy and therapy advice/support to parents, families and health professionals. Most children and adolescents who attend have a primary physical disability including cerebral palsy (GMFCS level IV-V), acquired brain injury or other more rare neurological conditions.

MDT Team: Consultant Pediatrician, Clinical Nurse Specialist, Physiotherapist, Occupational Therapist

General Referral Criteria:

• Diagnosis of Severe Complex Motor Disorder with significant physical disability i.e., predominantly diagnosis of Cerebral Palsy GMFCS levels IV and V
• Significant Spasticity/Dystonia:

• Spasticity or spasms that interfere with function or daily activities.
• Spasticity or spasms that interfere with care, comfort or positioning.
• Ineffective results or intolerable side effects (such as fatigue or nausea) from oral medications
• Spasticity-related pain
• Medication: Child has had at least a 6/12 trial of oral anti-spasmodic medication (such as Baclofen) and be approaching the maximal dose or maximal dose tolerated by the child.
• Age: 6-16y
• Weight: >20kg (preferable, but lower weights may be considered

General Exclusion Criteria:

• Age 16+ as these clients will be referred to Adult Complex Tone/ITB Service in Beaumont Hospital, Dublin.
• Child with GMFCS level I-III is referred to Spasticity (Ambulant) Management Team, CRC.

Note: Parental involvement and family/social circumstances are key to a successful ITB programme and are considered by the team as part of the assessment process but not in the initial referral process.

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Contact Email:

tonemanagement@crc.ie

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