Neurology

Description of Department/Service

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.

Patient Information - Sub Specialty Clinics

National Ataxia Clinic 

The National Ataxia Clinic 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

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.

Neuromuscular Clinic

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

You can read more information about Movement Disorders via the links below: 
http://www.move4parkinsons.com/
http://www.parkinsons.ie/

Referrals

Headache Pathway: Referral criteria for headache referrals to secondary care

Neurology External Referral Form