Clinical Neurophysiology is primarily an investigative specialty using computer, magnetic and electronic means to record the function of the brain, spinal cord, spinal roots, peripheral nerves and muscle to diagnose disorders of the nervous system.

Most tests are performed across all age groups, adult and paediatric. 

Key telephone numbers

01708 435 166

Clinic location

Neurophysiology Department
Ground floor, Orange zone
Queen’s Hospital
Rom Valley Way
Romford
Essex RM7 0AG

• Monday-Friday, 8am to 4.30pm

Key staff

Consultants in Clinical Neurophysiology: Dr Jacquie Deeb and Dr Nizar Muhammed

Senior chief physiologists: James Wall and Lesley O’Neill

Highly specialised physiologist: Cathy Jennings
Specialised physiologist: Prakriti Pyakurel

Secretaries: Helen Morgan and Julie Muller

Further information about our service
 

EMG (electromyography)

Used by clinicians to refer to both nerve conduction and EMG studies, which are usually carried out to diagnose disorders of the peripheral nerves or muscle. We also provide specialised tests like single fibre EMG study (voluntary and stimulation).
 

EEG (electroencephalography)

The recording of the electrical activity - measuring the brain waves. We provide routine EEG, sleep-deprived EEG, prolonged EEG and video-telemetry (for inpatients).

Sleep EEG

The entire test takes about two hours. This is a simple, painless procedure. It entails attaching several silver discs to the head with a special paste. We ask that you have four hours of sleep less than usual, and do not have any drinks to help keep you awake.

During the recording, (which takes about 60 minutes), you will be asked to relax - preferably lying down - and to close and open the eyes. For those unable to co-operate fully, we adapt this procedure as appropriate.

To obtain the best results we cannot have children in the examination room during this test.
In order to ensure the accuracy of the recording, please attend with your hair dry and washed within the previous 24 hours and do not apply any lacquer or other hair preparations.

You may eat and drink as normal and you should continue your medicines and tablets unless otherwise informed by your doctor. We will remove the paste from the hair at the end of the test but you may wish to wash the hair again later in the day. It would be helpful if you could bring your own comb or brush. There are no after effects. The results are not available immediately but will be sent to the doctor who requested the test.
 

EP (evoked potentials)

This records the responses of the brain to the stimulation of the senses. We perform the following studies:

• visual evoked potentials (VEP) where the patient is shown patterns or flashing lights
• auditory evoked potentials (AEP) where clicks are played through headphones
• Somato Sensory Evoked Potentials (SSEP) where small electrical pulses are applied to the arms and legs

VEP/AEP Evoked Potential Tests 

These are simple painless procedures. They entail attaching a few silver discs to your head with a special paste. During the visual test (VEP) you will be asked to look at a checkerboard pattern. Please make sure you attend with any glasses you have, or contact lens if you wear them. During the auditory test (AEP) you will be wearing headphones and we will be playing loud clicks into one ear at a time, for five minutes. During these periods you will be asked to sit quietly with your eyes closed. We will check your hearing level to the clicks before starting. If you wear earrings, you will need to remove these prior to this examination.

In order to ensure the accuracy of the recording please attend with your hair dry and washed within the previous 24 hours and do not apply any lacquer or other hair preparations. We will remove the paste from the hair at the end of the test but you may wish to wash your hair again later in the day. There are no after effects. Your technician will explain the test more fully when you attend. The results will be sent to your referring consultant.

Somato Sensory Evoked Potentials (SSEP)

This involves applying small electrical impulses to one of the nerves in your arms and/or legs, while recording from electrodes on your head and limbs. Your hands/feet will twitch. Although this might be slightly uncomfortable, this is not a painful test. The procedure will be fully explained to you on the day by the technician. Please allow 30 minutes for this test if we are only testing your arms or legs, or 60 minutes if we test both. There are no after effects.

IOM (intraoperative monitoring)

We monitor neurophysiological function during surgical operations on the brain, spinal cord and peripheral nerves, and EMG-guided botulinum toxin treatment for patients with movement disorders (such as dystonia) and spasticity.

We accept referrals from specialists (neurologists, neurosurgeons, orthopaedic surgeons, rheumatologists, pain specialists etc.) but not directly from general practitioners.

The Neuro-oncology service is concerned with conditions relating to brain and spinal cord tumours. This includes sub-specialist areas of brain tumour work such as tumours of the skull base (especially vestibular schwannoma), the pituitary region and the spine.

The Neuro-oncology multidisciplinary team, in line with National Institute of Health and Clinical Excellence guidelines, has weekly team meetings with neurosurgeons, neuropathologists, neuroradiologists and the Consultant Clinical Neuro-oncologist. Our Essex partners take part in a separate video-linked meeting which occurs bi-weekly on a Tuesday morning. These meetings enable information about patients to be shared and joint decisions to be made about the best care for each case.

Our Neuro-oncology Specialist Nurse is Kim Grove. Her role is to provide expert specialist advice, support and information to patients, carers and families on all aspects of brain and spinal tumours. She acts as a link between the patient and all the people that may be involved in the patient's care during the stay in hospital and in the community.

Kim can be contacted on 01708 435 000 ext 6745.

Neuropsychology is the study of brain-behaviour relationships. In the clinical setting we utilise a wide range of methods to assess brain function, emotions and behaviour in the context of suspected or confirmed neurological conditions. As part of our assessment we administer formal neuropsychological tests of memory, attention and speed of processing, language, visual perception and executive function. This information helps us to support diagnostic investigations and/or offer recommendations for ongoing psychological and neurorehabilitation care needs, and to help patients and families better understand their conditions or difficulties.

We are referred people with a wide range of neurological and neurosurgical conditions, such as:

• Memory difficulties and dementia
• Parkinson’s disease
• Multiple Sclerosis
• Neurovascular conditions
• Motor Neurone Disease
• Brain tumours
• Epilepsy
• Central Nervous System Infections
• Stroke
• Traumatic brain injury
• Hydrocephalus
• Deep brain stimulation

Key telephone numbers

01708 503 102

Clinic location

Department of Neuropsychology
Ground floor
Queen’s Hospital
Rom Valley Way
Romford
Essex, RM7 OAG

We request that patients report to the reception desk in the main atrium of the hospital.

Referral criteria

We accept referrals if the patient is under a Consultant Neurologists or Consultant Neurosurgeons. Patients must be aged 16 or above.

Key staff

• Consultant Clinical Neuropsychologist: Dr Charlotte Fuller
• Principal Clinical Neuropsychologist: Dr Leanne Brown
• Senior Clinical Psychologist: Dr Asma Torkamani
• Secretary: Lina Carroll

Strategies and resources to maintain psychological wellbeing during Covid-19

Our service includes the diagnosis of neurosurgical specimens from the brain and spinal cord. We also diagnose skeletal muscle/peripheral nerve biopsies and perform muscle biopsies via local anaesthesia and diagnosis.

We also carry out neuropathological autopsies including Creutzfeldt-Jakob-Disease, epilepsy, neurodegenerative disease, tumours and vascular disease.

Key telephone numbers

01708 435 000 ext 2980 or 2957 (neuropathology)
01708 435 000 ext 3553 (neuro admissions)
 

Clinic location

Queen’s Hospital
Pathology Block
Blue Zone
Second Floor
Queen's Hospital
Rom Valley Way
Romford
Essex, RM7 0AG

• Monday-Friday, 9am to 5.30pm

Referrals

Referral of specimens is via local neurosurgery. Referral of outpatients for muscle biopsy is via neuro admissions.

Key staff

Consultant Neuropathologists: Dr U Pohl and Dr D G O’Donovan
Chief Biomedical Scientist: Mr S Botwright

We perform most aspects of Interventional Neuroradiology in the department, both in terms of cranial as well as spinal intervention.

With cranial intervention, we offer embolisation of aneurysms, arterio venous malformations as well as carotid and intracranial stenting. Regarding spinal work, we perform kyphoplasty as well as CT guided spinal biopsies.

Key telephone numbers

01708 435000 ext 3599

Key staff

Consultant Neurosurgeon: Mr Vindlacheruvu

Consultant Neuroradiologist: Dr S Chawda, Dr S Derakhshani , Dr R Alkilani, Dr A Horsburgh and Dr S Rosa

 

                       

Our neurosurgical unit offers a wide range of treatments for disorders of the brain, the spine and peripheral nerves in adults. The unit provides the regional neurosurgical service for Essex and its surrounding areas. Our adult neurosurgery service include the specialty programmes of brain tumors, cerebrovascular disorders, spine, functional and peripheral nerves.

The department is equipped with a dedicated neuro-intensive care unit, neurosurgical theatre suits and a neurosurgical ward. We have an important role in training junior neurosurgeons and undergraduate students. We contribute to research and the department is actively recruiting to multiple clinical trials including international research projects. We work in close collaboration with consultants from other specialties, including ear nose and throat, maxillo-facial and plastic surgery.

The neurosciences therapy team consists of both Occupational and Physiotherapists. We fulfill a variety of roles which reflect the acute nature of neurosciences. 

Our therapists are key members of the multidisciplinary team and receive referrals at handovers and on ward rounds. We are involved in Trust initiatives including improvement in patient care pathways and other service development projects. The team has links throughout the Essex region and with neuroscience colleagues across London.

Key telephone numbers

01708 435 000 ext 3103

Clinic location

Integrated Therapies department
Ground floor
Queen’s Hospital
Rom Valley Way
Romford
Essex, RM7 0AG

• Monday to Friday, 8am to 4.30pm (plus an on-call/weekend respiratory physiotherapy cover)

 

Physiotherapy role

Working on a regional neurosurgical specialist unit, advanced skills are required incorporating acute respiratory care, neurological assessment and rehabilitation and also long term condition planning.
 

Our responsibilities include:

• Critical care chest physiotherapy, weaning and early rehabilitation
• 24 hour on call service for critically ill patients
• assessment and treatment of patients with traumatic and non-traumatic brain injury, spinal injury and other neurological conditions
• specialist advice on prescribed orthotic devices including supply and fitting of hard collars
• providing advice and information leaflets following spinal surgery
• early identification of rehabilitation needs and referral to other services
• inpatient rehabilitation (local patients on ANSRU)
• an outreach service to other wards for non-surgical spinal injury and brain injured patients
• neuro and respiratory training for internal and external health care professionals.

Occupational therapy role

Occupational therapists working in neurosciences have a varied role, demanding specialist skills in physical and cognitive areas including:

• initial interview and review of social history / home circumstances
• assessment and fitting of wheelchairs including specialist seating
• cognitive and perceptual assessment / standardised batteries
• communication work including non-verbal and verbal strategies
• indentification and referral to address patient’s discharge needs including care packages and equipment
• discharge planning. This may include case conferences and liaising with families and other agencies
• functional assessments including personal care and meal preparation
• access visits (determining home layout) and home assessments (with patients)
• training carers/family members
• rehabilitation in critical care (cognitive approaches, seating and splinting) and on the wards (practicing functional activities)
• upper limb splinting/exercises
• inpatient rehabilitation (local patients on ANSRU)

Discharge planning is a significant part of the role and we use information gained from interview and functional assessment (of everyday tasks), in order to determine the needs of patients in our care. The occupational therapists may recommend equipment, techniques and or services to promote safety and independence at home following surgery and for managing long- term conditions. 

Key staff

Clinical Lead Occupational Therapist / Team Lead: Mark Wainwood.

Specialist Neuro Physiotherapist: Charlotte Turnpenny.

Our stroke service is part of the Regional Neuroscience Centre. It provides inpatient and outpatient services for patients who have had a stroke or who are suspected of having had one.

As our stroke service is situated within the tertiary neuroscience centre, it has access to state-of-the-art equipment and a wealth of expertise. It also works closely with the Neuroradiology and Neuro Vascular Surgery departments to ensure patients receive rapid diagnosis and treatment. Patients who are suspected of having a stroke are admitted to the Hyper Acute Stroke Unit for evaluation which may include the following tests: a CT scan, a carotid artery Doppler and ECG (electrocardiogram).

The Hyper acute stroke unit (HASU) is one of eight designated Hyper acute stroke units in London, with approximately 1600 inpatients seen each year and a further 500 stroke outpatients. We are one of the busiest stroke units in London. Our therapist is unique in their experienced approach towards stroke patients and use well balanced care whilst striving to provide evidence-based treatment.

We aim to promote stroke research to our doctors, nurses  and patients which also  provides opportunities for collaboration. Our research interests include stroke genetics, stroke imaging and treatment of diseased carotid arteries.

For further advice and information regarding strokes please visit the Stroke Association website or call them on 0303 3033 100.