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.

Contact Email:

Download the Referral Form

Return to
or Specialist Services Referrals, CRC, Vernon Avenue, Clontarf, Dublin 3