National Ataxia Clinic
The National Ataxia Clinic in TUH is a designated centre of expertise. This is a multidisciplinary clinic, co-directed by Professors Sinéad Murphy and Richard Walsh, Consultant Neurologists. The clinic, staffed by three consultants, runs on the first Friday of every month and referrals are accepted from GPs or specialists within the Republic of Ireland. External referrals are also received, mainly from Northern Ireland. Approximately 150 patients attend the clinic annually. The vast majority of patients attending the clinic have genetically determined ataxia. Four times per year we run a Combined Ataxia Clinic with Dr Deirdre Ward, a Cardiologist with a special interest in inherited cardiac disorders. This allows same day Neurological and Cardiac assessment for patients predominantly with Friedreich’s Ataxia. Blood tests (routine and genetic), imaging, ECG and Echocardiogram are performed on the same day as clinic where possible, as clinically indicated. Patients attending the clinic have access to Allied Health Care Professionals including Physiotherapy, Occupational Therapy, Speech and Language Therapy, Neuropsychology, Dietetics and Medical Social Work. There is well established collaboration with different ataxia centres and genetic laboratories across Europe. After discussion of undiagnosed patients at our Ataxia MDT meetings Dr. Bogdanova-Mihaylova collects further data, including seeing family members where required, taking DNA for more specific genetic testing, which often requires organising additional visits outside the Ataxia Clinic hours.
You can read more information about the Ataxia Clinic via this link.
Neurology Cognitive Clinic
The TUH Neurology Cognitive Clinic is a multi-disciplinary clinic directed by Dr. Seán O’Dowd, Consultant Neurologist. It is staffed by Dr. O'Dowd, a neurology registrar and Clinical Nurse Manager in Neurology (CNM) Emmet Kelly.
The clinic runs every Tuesday morning. Neurology referrals from GP and other hospital consultant teams are reviewed, triaged and allocated to the Neurology cognitive clinic if there is a cognitive element in the referral. Conditions diagnosed and treated in this clinic include Alzheimer’s disease, Lewy Body disease, frontotemporal dementia, progressive supranuclear palsy, corticobasal syndrome. Approximately 170 new patients are seen in the clinic annually.
Patients are sent out a Patient Information Leaflet with their appointment. The function of this is to inform attendees what to expect at the clinic and to suggest bringing a family member or someone who may be able to provide further collateral history.
The assessment process begins with the CNM performing standardised cognitive assessments. The family/patient provide further information for the assessment through completion of a questionnaire and a separate meeting with the nurse specialist. Patients are screened for possible mood and anxiety issues which may influence cognition. A full neurological history and examination takes place with the Neurology team. The clinic has access to blood, radiological and neuro-physiological tests. Referrals are made to neuropsychology and other allied healthcare professional as appropriate.
If and when a diagnosis is made by the Consultant Neurologist, advice is given on supports available for both patient and carers. Contact details of the Neurology Nurse are given to patients and families. Links have been developed with national organisations such as the Alzheimer’s Association and PSP Ireland. Links with the UK Lewy Body society have also been made.
You can read more information about the Neurology Cognitive Clinic via this link.
Peripheral Neuropathy Clinic
The Peripheral Neuropathy Clinic in TUH is a multidisciplinary clinic which runs alternate weeks. The members of the team are Dr. Sinéad Murphy, Consultant Neurologist, Dr. Michael Alexander, Consultant Neurophysiologist, a Specialist Registrar and a visiting/research fellow on occasion. Dr. Murphy has sub-specialty expertise in genetic neuropathies including Charcot-Marie-Tooth disease and related disorders, hereditary TTR amyloidosis and inflammatory neuropathies such as CIDP, multifocal motor neuropathy and paraproteinaemic neuropathies. Blood tests (routine and genetic), radiology and ECG are performed on the same day as clinic, as clinically indicated. New patients may also have Nerve Conduction Studies / EMG on the same day as clinic where indicated. Patients attending the clinic have access to Allied Health Care Professionals including Physiotherapy, Occupational Therapy, Speech & Language Therapy, Neuropsychology, Dietitian and Medical Social Worker. There are established links with a cardiologist with expertise in inherited cardiac conditions allowing direct referral when required and access to national genetics service via referral.
We accept referrals from GPs and various specialists across the island of Ireland.
The Neuromuscular Clinic in TUH runs every second week. The members of the team are Dr. Sinéad Murphy, Consultant Neurologist, a Specialist Registrar and on occasion a visiting/research registrar. On the same day as clinic, if required, patients may have Neurophysiology testing, radiology, ECG and blood tests (routine and genetic). Patients attending the Neuromuscular Clinic also have access to Physiotherapy, Occupational Therapy, Speech & Language Therapy, Neuropsychology, Dietitian and Medical Social Worker. There are established links with a cardiologist with expertise in inherited cardiac conditions allowing direct referral when required and access to national genetics service via referral. We accept referrals from GPs and various specialists on the island of Ireland
Movement Disorder Clinic
The term ‘Movement Disorder’ refer to a group of nervous system conditions that cause abnormal increased/decreased movements. The TUH Movement Disorder Clinic provide assessment, diagnosis and treatment for people living with a movement disorder.
TUH is one of the leading centres for Movement Disorder covering numerous counties in Ireland. The clinic is coordinated by Prof Richard Walsh and Dr Allan Mc Carthy. Nicola Kavanagh is the Parkinson’s Disease CNSp and is employed on a part time basis.
Patients are referred to members of the multi-disciplinary team such as Physiotherapy, Occupational Therapy, Dietetics, Speech and Language Therapy, Neuropsychology and Medical Social work. Referrals are also made to community services and Primary care teams. Patients are referred for genetic testing where appropriate. The most common types of Movement Disorders are Parkinson’s disease, Dystonia and Essential Tremor.
Patients also attend the clinic with diagnoses of the following; Progressive Supranuclear Palsy (PSP), Multiple System Atrophy (MSA), Lewy Body Disease (DLB), Blepharospasm, Huntington’s Disease (HD), Myoclonus, Restless Leg Syndrome, Chorea, Tardive Dyskinesia, tic disorders and Wilson’s Disease.
We also provide more advanced treatments such as;
- Apo-morphine and Duodopa Therapy for Parkinson’s Disease
- Botulinum toxin therapy for Dystonia
We also assess and evaluate patients with movement disorders in view of undergoing Deep Brain Stimulation. Professor Walsh is the clinical lead in the National Deep Brain Stimulation programme in the Mater University Hospital, Dublin. He works across both sites allowing for greater links between the two centres.
You can read more information about Movement Disorders via the links below:
The Headache Clinic
The Headache Clinic at TUH is a multi-disciplinary clinic. It is directed by Dr. Petya Bogdanova-Mihaylova, Consultant Neurologist. The members of the team include Dr. Claire Hannon, General Practitioner with a special interest in Headache Disorders, Sharon Moran, Clinical Nurse Specialist and Michelle Loftus, Clinical Psychologist.
The clinic runs weekly and is located in the Simms Building. Referrals are accepted from General Practitioners and various other specialties within the Hospital. The Headache Clinic provides assessment, diagnosis, treatment and education for people living with headache conditions such as Migraine, Medication Overuse Headache, Cluster Headache, Occipital Neuralgia, and other primary and secondary headache disorders.
Patients attending the Headache Clinic have access to Greater Occipital Nerve Block, as well as to more advanced treatments such as Botulinum toxin injections and Calcitonin Gene related Peptide injections. Patients are referred to Psychology, Physiotherapy and other allied healthcare professional as required. There are established links with the Migraine Association of Ireland and the Irish Pharmacy Union. To find out more about the Headache Clinic and medication overuse in the management of headaches click on this link
In this video, Dr. Claire Hannon a specialist GP working in the Headache Clinic discusses how to manage an acute migraine attack. The different types of medications available to treat migraine attacks, it also outlines a step-by –step approach to the treatment of a migraine attack.
The Department of Neurology in TUH is currently staffed by four full-time consultant neurologists, Professor Sinead Murphy, Professor Richard Walsh, Dr Seán O’Dowd, and Dr. Allan McCarthy. Professor Dominick McCabe is involved in patient care and research. Their work is supported by two Nurse Specialists, one in Parkinson’s disease (Nicola Kavanagh) and one in multiple sclerosis (Nadia Macken), one Advanced Nurse Practitioner in epilepsy (Denise Cunningham), as well as one CNM in Neurology and two Research Neurology Nurses. The department is closely linked, within the Academic Unit of Neurology in Trinity College, to the Department of Clinical Neurophysiology run by Dr. Michael Alexander and his colleague Dr. John McHugh, Consultant Neurophysiologists and a team of specialist technicians. Also contributing to the work of the team is Dr. Garret McDermott a Neuropsychologist.
Sub-specialty clinics in neurology run throughout the week catering for movement disorders, advanced therapeutic options in Parkinson’s disease, inherited neuropathies, neuromuscular diseases, cerebellar ataxias, cognitive disorders and stroke neurology. The National Ataxia Clinic is the only clinic in the country dedicated to the investigation and management of inherited cerebellar ataxia. Along with colleagues in Age Related Health Care, the department provides a same day assessment and investigation of urgent referrals for patients with a suspected transient ischaemic attack. Each consultant runs a general neurology clinic where all neurological conditions are investigated and managed. The department is proud to work alongside a full complement of highly experienced allied health professionals with specific expertise in neurology, representing neuropsychology, physiotherapy, occupational therapy, speech & language therapy and medical social work. The department enjoys a tightly knit collaborative framework of practice across all members of the team that we believe enhances patient outcomes.
All consultants within the Department are actively involved in research, supervising Research Fellows in Movement Disorders & Ataxia and Stroke Neurology.
In 2016 the Raymond P Murphy Neurology Assessment and Research Unit was opened to provide a dedicated space for the evaluation, education and research of patients with chronic neurological disease. The unit is equipped with an ocular coherence tomography machine, which provides high-resolution three-dimensional images of the retina and its layers.