Clinical Neurophysiology

Clinical Neurophysiology is an investigative speciality allied to Neurology. Whilst neurological diagnosis in both adults and children is the primary remit of clinical work, the speciality also encompasses functional monitoring for neurosurgical procedures such as brain and spinal surgery, and a therapeutic component with EMG-guided botulinum toxin therapy. Some clinical neurophysiologists also clinically manage patients with epilepsy, neuropathy or sleep disorders. It has roles also in the monitoring of the progress of disease, and the effects of therapy, working in conjunction with the clinician in charge of a patient to define the most appropriate management. The majority of the clinical work is outpatient-based, and the clinical neurophysiologist works closely not only with neurologists, but also with neurosurgeons, plastic and trauma surgeons and generalists such as geriatricians and paediatricians. A significant proportion of referrals are made by general practitioners. Inpatient referrals are typically from intensive care units and the acute care wards.

This is a 4 year training programme (entry at ST3) leading to CCT in Clinical Neurophysiology. Training takes place principally in the Oxford University Hospital Trust in the Thames Valley region. Trainees may rotate through the John Radcliffe Oxford (part of the Oxford University Hospitals Trust) and other hospitals in the region (which include the Royal Berkshire Hospital, Northampton General Hospital and Great Western Hospital). Some training also takes place extra-regionally, including national training days and specific training attachments.

Clinical Neurophysiology training is led by four consultants in Oxford, and two in Northampton. Neurophysiology training is principally outpatient-based and clinics take place in a purpose-built department in the West Wing, John Radcliffe Hospital. Onew year of the programme is dedicated to Neurology, with training in Oxford and surrounding district hospitals. There are supervised EMG clinics for a wide range of adult and paediatric neuromuscular disorders for which Oxford is a supra-regional and national centre, and EEG reporting sessions for adults and children with epilepsy.

The programme also includes a training component in sleep disorders, incorporating a variety of EEG/polysomnography procedures based at the John Radcliffe Hospital, as well as reporting sessions for evoked potentials used in the diagnosis of disorders of the optic nerve and retina, and the spinal cord.

The Training Programme Director is Dr Mkael Symmonds: