Neurology

Description of Department/Service

The Department of Neurology in Tallaght University Hospital is currently staffed by three full-time consultant neurologists, Dr. Sinead Murphy, Dr. Richard Walsh and Professor Dominick McCabe. Their work is supported by two Nurse Specialists, one in Parkinson’s disease (Nicola Kavanagh) and one in multiple sclerosis (Nadia Macken), as well as an Advanced Nurse Practitioner in epilepsy (Denise Cunningham). The department is closely linked, within the Academic Unit of Neurology in Trinity College, to the Department of Clinical Neurophysiology run by Dr. Mike Alexander and his colleague Dr. John McHugh, Consultant Neurophysiologists and their staff of specialist technicians.

Sub-specialty clinics in neurology run throughout the week catering for movement disorders, advanced therapeutic options in Parkinson’s disease, inherited neuropathies, neuromuscular disease, ataxia, 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 and 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.

Neurology – Dr. Richard Walsh

Dr. Richard Walsh joined the department in 2012 when he took on the practice of Dr. Raymond Murphy upon his retirement. Dr. Walsh completed his specialty training in Ireland, which included a Clinical Fellowship in Movement Disorders with a focus on dystonia and its management with botulinum toxin. From 2010 to 2012, Dr. Walsh completed two further clinical fellowships in Parkinson’s disease and Deep Brain Stimulation in Movement Disorders, when working with Professor Anthony Lang and Dr. Elena Moro in Toronto Western Hospital as the Parkinson Society Canada Fellow and Edmund J Saffra Fellow in Movement Disorders respectively. Dr. Walsh returned to Dublin to join the staff in Tallaght Hospital where he set up the Tallaght Hospital Movement Disorders Unit in 2013, for which he has secured funding for a Parkinson’s disease Nurse Specialist and a Clinical Fellow in Movement Disorders. Dr. Walsh is the co-director of the National Ataxia Clinic with his consultant colleague Dr. Sinead Murphy. Dr. Walsh’s main research interest is the management motor fluctuations in advanced Parkinson’s disease and the role of deep brain stimulation in Parkinson’s disease and other movement disorders. He is currently the only Irish member of the DBS-Links group, a small group of neurologists in southern England and the Channel Islands who provide a satellite deep brain stimulation service for patients undergoing deep brain stimulation procedures in London. This service is aimed at maximising the potential for Irish patients to avail of deep brain stimulation in the UK and minimising the inconvenience of travel involved in the process.

Patient Information

National Ataxia Clinic 
The National Ataxia Clinic in TUH is a designated centre of expertise. This is a multidisciplinary clinic, co-directed by Drs Sinéad Murphy and Richard Walsh, Consultant Neurologists. The clinic is staffed by the two consultants, the ataxia research registrar, Dr. Petya Bogdanova-Mihaylova, and an ataxia nurse specialist, Sharon Moran.

This clinic 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 and 40% of new referrals are second opinions from other Neurology Centres. 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 enables 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

http://www.move4parkinsons.com/

http://www.parkinsons.ie/

Referrals

Headache Pathway: Referral criteria for headache referrals to secondary care

Neurology External Referral Form