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Auckland Medical Specialists (AMS) - Neurology Services

Private Service, Neurology, Older People's Health, Psychiatry

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Description

What is Neurology?
Neurology is the study of the nervous system (brain, spinal cord and nerves), how it controls various parts of the body and the diseases and disorders that may affect it.
 
The brain coordinates how we think and what we do physically as well as controlling how the body manages itself.  It sends messages to, and receives information from, the rest of the body via a complex system of nerves which use chemicals and electricity to send information.
 
The nervous system can be divided into the
  • voluntary nervous system which controls what we choose to do and the
  • involuntary or autonomic nervous system that controls automatic functions that we don’t have to think about.
 A medical specialist in this field is a Neurologist.  A Neurosurgeon is a surgeon who operates on parts of the nervous system.  The two specialists often work together, depending on the problem.

Staff

Our Neurology team is filled with highly experienced general Neurologists who each have special interests as listed below. 

Prof Alan Barber - Stroke 
Dr Alison Charleston - MND, Geriatric
Dr Barry Snow - Parkinsons 
Dr Edward Wong - Stroke 
Dr Kiri Brickell - Cognitive 
Dr Elizabeth Walker - Epilepsy 
Dr Peter Bergin - Epilepsy 
Dr Rosamund Hill - Headache/Migrane 
Dr Sunayana Sasikumar - Epilepsy 
Dr Viswas Dayal - DBS, Movement disorder
Dr Richard Frith & Dr Dean Kilfoyle - NCS/EMG only 
Dr Rakesh Patel - General paediatric

Consultants

How do I access this service?

Referral

Our specialists will accept patients by referral only

Referral Expectations

Your GP will refer you to see a neurologist if they think you have a problem that involves the nervous system and that needs specialist help in diagnosing or treating that condition.
 
A history of your symptoms will be taken as well as a review of any medications you are on (so please bring these with you).  The doctor may also review any old notes and previous problems you have had. 
You will then be examined which may include a general examination as well as an examination of the nervous system.  An examination of the brain and nerves may include testing your memory and concentration as well as other aspects of thinking processes.  It also involves examining how well the nerves to your head and body are working. You may have further testing to establish the diagnosis.
 
The specialist will discuss with you the possible diagnosis and what further tests or treatments are recommended.  They will correspond with your GP about your diagnosis, results of tests and a treatment plan.  
 
You may also be referred to a physiotherapist or occupational therapist.  A physiotherapist provides physical therapy to assist with any disability you have.  An occupational therapist reviews what equipment/advice will assist in activities of daily living if you have a disability. 
 
ACC Patients
A patient's referring doctor must first send a letter to ACC requesting coverage for a neurological consultation - a Claims Manager will then be assigned to the patient. The Claims Manager will courier the referring documents to us and include with the documents a purchase order number under the service code MSDA1 or MSDA2.  Both the purchase order number and a service code from the Case Manager are needed to cover the specialist neurological consultation, and we can not see any ACC patients without these.
 
The exception here is with ACC Nerve Conduction Studies and EMGs - no purchase order number or service code is required for these specific tests.

Fees and Charges Categorisation

Fees apply

Fees and Charges Description

Initial Consultation:          The fee varies per Doctor

 

Follow-Up Consultation:  The fee varies per Doctor

 

Health Insurance Claims

Southern Cross Health Insurance: 

Some, but not all, of the neurologists at Auckland Medical Specialists have elected to become part of the Southern Cross Affiliated Provider Programme. If you have Southern Cross health insurance and have an appointment to see a neurologist on the Affiliated Provider Programme, we will gain prior approval from Southern Cross for your appointment on your behalf. We will let you know at the time of your appointment if there is any payment shortfall to be made. Any shortfall will be dependent on your insurance policy.

If you have an appointment to see a neurologist who has opted not be part of the Affiliated Provider Programme, you will not be able to make a claim from Southern Cross for the appointment unless you have an Ultracare policy.  

Please check with Southern Cross Health Insurance if you have any queries regarding your policy, the Affiliated Provider Programme and the recent significant changes that Southern Cross Health Insurance have made regarding claiming for specialist consultations.

All other Health Insurance Companies:

If you have health insurance with any other insurance company you will be required to pay at the time of your consultation and send the receipt to your insurance company for reimbursement (depending on your policy).  You may wish to apply to your insurance company for prior approval for the consultation for your own peace of mind. However you will still be asked to pay in full at the time of your consultation.

Hours

Mon – Fri 8:00 AM – 5:30 PM
Sat 8:00 AM – 1:00 PM

Occasional early evening and Saturday morning appointments available.

Closed on Public Holidays

Public Holidays: Closed Auckland Anniversary (27 Jan), Waitangi Day (6 Feb), Good Friday (18 Apr), Easter Sunday (20 Apr), Easter Monday (21 Apr), ANZAC Day (25 Apr), King's Birthday (2 Jun), Matariki (20 Jun), Labour Day (27 Oct).
Christmas: Open 23 Dec — 24 Dec. Closed 25 Dec — 26 Dec. Open 27 Dec — 28 Dec. Closed 29 Dec. Open 30 Dec — 31 Dec. Closed 1 Jan — 2 Jan. Open 3 Jan — 4 Jan. Closed 5 Jan. Open 6 Jan — 10 Jan.

Common Conditions / Procedures / Treatments

Electroencephalogram (EEG)

An EEG is a test to detect abnormalities in the electrical activity of the brain. Cells in the brain communicate with each other via electrical activity. In an EEG, electrodes are placed on the scalp over multiple areas of the brain to detect and record the patterns of electrical activity. An EEG technician performs the test. You will be asked to lie on your back on a bed. The technician will apply between 16 and 25 flat metal discs (electrodes) in different positions on your scalp. The discs are held in place with a sticky paste. Your head is not shaved for this. The electrodes are connected to a recording machine, which converts the electrical signals into a series of wavy lines that are drawn onto a moving piece of graph paper. You will need to lie still with your eyes closed because any movement can alter the results. Although having electrodes pasted onto your skin may feel strange, they only record activity and do not produce any sensation. There are no risks from this test. Your doctor may want you to stop some medications before the test. You should avoid all food and drink containing caffeine for 8 hours before the test. Sometimes it is necessary to sleep during the test, so you may be asked to reduce your sleep time the night before. EEGs are used to help diagnose the presence and type of epilepsy (fits/seizures), to look for causes of confusion and to assess various diseases that affect the brain. They are also used to evaluate sleep disorders and to investigate periods of unconsciousness. The test will need to be interpreted afterwards so the results will not be available at the time of the test but will be sent to the referring doctor.

An EEG is a test to detect abnormalities in the electrical activity of the brain. 
Cells in the brain communicate with each other via electrical activity. In an EEG, electrodes are placed on the scalp over multiple areas of the brain to detect and record the patterns of electrical activity.
An EEG technician performs the test.  You will be asked to lie on your back on a bed. The technician will apply between 16 and 25 flat metal discs (electrodes) in different positions on your scalp. The discs are held in place with a sticky paste. Your head is not shaved for this. The electrodes are connected to a recording machine, which converts the electrical signals into a series of wavy lines that are drawn onto a moving piece of graph paper. You will need to lie still with your eyes closed because any movement can alter the results. Although having electrodes pasted onto your skin may feel strange, they only record activity and do not produce any sensation. There are no risks from this test.
 
Your doctor may want you to stop some medications before the test.
You should avoid all food and drink containing caffeine for 8 hours before the test.
Sometimes it is necessary to sleep during the test, so you may be asked to reduce your sleep time the night before. 
 
EEGs are used to help diagnose the presence and type of epilepsy (fits/seizures), to look for causes of confusion and to assess various diseases that affect the brain.
They are also used to evaluate sleep disorders and to investigate periods of unconsciousness.
 
The test will need to be interpreted afterwards so the results will not be available at the time of the test but will be sent to the referring doctor.
Nerve Conduction Studies (NCS)

NCS are tests of the speed of conduction of impulses through a nerve. A doctor performs the tests. The nerve is stimulated, usually with electrodes placed on the skin. One electrode stimulates the nerve with a very mild electrical impulse and the other electrodes record the resulting electrical activity. The impulse will feel like a small electric shock. Depending on how strong the stimulus is you will feel it to varying degrees and it may be uncomfortable for you. You should feel no pain once the test is finished. This test is used to diagnose nerve damage or destruction. Information from the test can tell the doctor what part of the nerve is damaged and give an idea as to the disease causing the damage. There are no risks from this test. The test will need to be interpreted afterwards so the results will not be available at the time of the test but will be sent to the referring doctor.

NCS are tests of the speed of conduction of impulses through a nerve.  A doctor performs the tests.
 
The nerve is stimulated, usually with electrodes placed on the skin. One electrode stimulates the nerve with a very mild electrical impulse and the other electrodes record the resulting electrical activity.
 
The impulse will feel like a small electric shock. Depending on how strong the stimulus is you will feel it to varying degrees and it may be uncomfortable for you. You should feel no pain once the test is finished.
This test is used to diagnose nerve damage or destruction.  Information from the test can tell the doctor what part of the nerve is damaged and give an idea as to the disease causing the damage. There are no risks from this test.
 
The test will need to be interpreted afterwards so the results will not be available at the time of the test but will be sent to the referring doctor.
Electromyography (EMG)

EMG is a test that assesses disorders of muscles and the nerves controlling them. A doctor performs this test. For an EMG, a needle electrode is inserted through the skin into the muscle. The electrical activity detected by this electrode is displayed on a monitor. This is usually performed after a nerve conduction study. You may be asked to contract the muscle (for example, by bending your arm) which will give the doctor information about how muscles respond to messages from nerves. There may be some discomfort with the insertion of the electrodes (similar to an injection into a muscle). Afterwards, the muscle may feel tender or bruised for a few days. There is a very low risk of bleeding or infection at the site of the needle but this is minimal. EMG is most often used when people have symptoms of weakness and examination shows impaired muscle strength. It can help to tell the difference between problems with a muscle versus problems with the nerves supplying the muscle.

EMG is a test that assesses disorders of muscles and the nerves controlling them. A doctor performs this test.
For an EMG, a needle electrode is inserted through the skin into the muscle. The electrical activity detected by this electrode is displayed on a monitor.  This is usually performed after a nerve conduction study.
You may be asked to contract the muscle (for example, by bending your arm) which will give the doctor information about how muscles respond to messages from nerves.
 
There may be some discomfort with the insertion of the electrodes (similar to an injection into a muscle). Afterwards, the muscle may feel tender or bruised for a few days.
 
There is a very low risk of bleeding or infection at the site of the needle but this is minimal.
 
EMG is most often used when people have symptoms of weakness and examination shows impaired muscle strength. It can help to tell the difference between problems with a muscle versus problems with the nerves supplying the muscle.
Radiology

Computer Tomography (CT) A CT image is created by using an X-ray beam, which is sent through the body from different angles giving cross-sectional images of the body. This is a common test that gives information about any structural abnormalities of the brain. Magnetic Resonance Imaging (MRI) This procedure uses a combination of magnetic fields and radio waves (not x-rays) which results in an exact, clear image of body structures. It gives detailed information about problems with the brain or spinal cord.

Computer Tomography (CT)
A CT image is created by using an X-ray beam, which is sent through the body from different angles giving cross-sectional images of the body.
This is a common test that gives information about any structural abnormalities of the brain. 
 
Magnetic Resonance Imaging (MRI)
This procedure uses a combination of magnetic fields and radio waves (not x-rays) which results in an exact, clear image of body structures.
It gives detailed information about problems with the brain or spinal cord.
Epilepsy

Epilepsy is a condition where people have seizures or ‘fits’. Seizures may present in many forms but are due to bursts of electrical activity within the brain. The problem can be with the electricity of the brain on its own or due to some underlying structural lesion of the brain. Anyone can have a seizure if the stimulus is great enough to exceed a threshold in the brain. Factors such as fever, changes in blood chemistry, anxiety, sleep deprivation or alcohol may influence the onset of a seizure. Although some disorders and traumas play a role in developing epilepsy most people who have epilepsy have no known reason. A seizure may present as a convulsion, unusual body movement, a change in awareness or simply a blank stare. The person may be unconscious or completely unaware of what is happening. What type of symptoms people have depends on what part of the brain is involved. The diagnosis of epilepsy is made on the basis of the history so it is useful when you come to clinic if someone who has witnessed an event can come with you. Depending on your symptoms and examination findings you may undergo an EEG test and/or an MRI of your brain to aid in the diagnosis and planning of treatment. Not everyone needs these tests and the doctor will talk with you about what is needed. Epilepsy is usually treated with medication to prevent seizures. There will also be implications for driving if you are diagnosed with this condition, as it needs to be well controlled before you can drive. Your doctor will discuss this with you. For more information visit www.epilepsy.org.nz

Epilepsy is a condition where people have seizures or ‘fits’.  Seizures may present in many forms but are due to bursts of electrical activity within the brain.   The problem can be with the electricity of the brain on its own or due to some underlying structural lesion of the brain.
 
Anyone can have a seizure if the stimulus is great enough to exceed a threshold in the brain. Factors such as fever, changes in blood chemistry, anxiety, sleep deprivation or alcohol may influence the onset of a seizure.  Although some disorders and traumas play a role in developing epilepsy most people who have epilepsy have no known reason. 
 
A seizure may present as a convulsion, unusual body movement, a change in awareness or simply a blank stare. The person may be unconscious or completely unaware of what is happening.  What type of symptoms people have depends on what part of the brain is involved.
 
The diagnosis of epilepsy is made on the basis of the history so it is useful when you come to clinic if someone who has witnessed an event can come with you.  Depending on your symptoms and examination findings you may undergo an EEG test and/or an MRI of your brain to aid in the diagnosis and planning of treatment.  Not everyone needs these tests and the doctor will talk with you about what is needed.
 
Epilepsy is usually treated with medication to prevent seizures.  There will also be implications for driving if you are diagnosed with this condition, as it needs to be well controlled before you can drive.  Your doctor will discuss this with you.
For more information visit www.epilepsy.org.nz
Parkinson's Disease

Parkinson's disease is a disorder of the brain characterised by shaking (tremor), slowing of movement and difficulty with walking and coordination. The disease is due to progressive deterioration of the cells in the part of the brain that controls muscle movement. The disorder may affect one or both sides of the body, with varying degrees of loss of function. Symptoms include: shaking (not always present), stiffness, loss of balance, shuffling walk, slow movements, difficulty initiating any voluntary movement, muscle aches and pains, reduced ability to show facial expressions, voice or speech changes, difficulty writing (may be small and hard to read), difficulty with any activity that requires small movements. Diagnosis is usually made on the history and with an examination, with no need for further testing unless there is some uncertainty. There are some diseases that can mimic Parkinson’s disease. There is no known cure for Parkinson's disease. Treatment is aimed at controlling the symptoms. Many of the medications can cause severe side effects, so monitoring and follow-up by doctors is important. For more information about Parkinson’s disease and related conditions as well as support groups in New Zealand visit www.parkinsons.org.nz

Parkinson's disease is a disorder of the brain characterised by shaking (tremor), slowing of movement and difficulty with walking and coordination. The disease is due to progressive deterioration of the cells in the part of the brain that controls muscle movement. The disorder may affect one or both sides of the body, with varying degrees of loss of function.
 
Symptoms include: shaking (not always present), stiffness, loss of balance, shuffling walk, slow movements, difficulty initiating any voluntary movement, muscle aches and pains, reduced ability to show facial expressions, voice or speech changes, difficulty writing (may be small and hard to read), difficulty with any activity that requires small movements.
 
Diagnosis is usually made on the history and with an examination, with no need for further testing unless there is some uncertainty.  There are some diseases that can mimic Parkinson’s disease.
 
There is no known cure for Parkinson's disease. Treatment is aimed at controlling the symptoms. Many of the medications can cause severe side effects, so monitoring and follow-up by doctors is important.
For more information about Parkinson’s disease and related conditions as well as support groups in New Zealand visit www.parkinsons.org.nz
Headaches/Migraines

Most headaches are not due to significant underlying problems but you may be referred if your GP is worried about the nature of your headaches or you are having difficulty controlling them with standard treatment. Migraine headaches are repeated or recurrent headaches, often accompanied by other symptoms. They can be triggered by certain factors/events/foods. In some people, a visual disturbance called an aura happens before the headache starts. Other symptoms that may precede or accompany the headache include loss of appetite, nausea, vomiting, increased sweating, irritability, fatigue, intolerance of light or noise. The headache may last several hours to days. Prior to coming to clinic for review of headaches it is useful to keep a diary. Write down: when your headaches occurred, how severe they were, additional symptoms, what you've eaten, sleep patterns, menstrual cycles, any other possible factors. There is no cure for migraine headaches but treatment is aimed at: preventing migraines from occurring, stopping the migraine once early symptoms develop, and treating the symptoms of migraine (e.g. pain, nausea).

Most headaches are not due to significant underlying problems but you may be referred if your GP is worried about the nature of your headaches or you are having difficulty controlling them with standard treatment.
 
Migraine headaches are repeated or recurrent headaches, often accompanied by other symptoms. They can be triggered by certain factors/events/foods. In some people, a visual disturbance called an aura happens before the headache starts.  
Other symptoms that may precede or accompany the headache include loss of appetite, nausea, vomiting, increased sweating, irritability, fatigue, intolerance of light or noise.  The headache may last several hours to days.
 
Prior to coming to clinic for review of headaches it is useful to keep a diary. Write down: when your headaches occurred, how severe they were, additional symptoms, what you've eaten, sleep patterns, menstrual cycles, any other possible factors.
 
There is no cure for migraine headaches but treatment is aimed at: preventing migraines from occurring, stopping the migraine once early symptoms develop, and treating the symptoms of migraine (e.g. pain, nausea).
Multiple Sclerosis (MS)

Multiple sclerosis is a progressive disease involving the brain and spinal cord. It occurs over time in multiple sites in these two areas of the nervous system. The cause is not known but it is thought that a person’s immune system for some reason attacks the sheath that surrounds and protects nerves, causing inflammation, scarring and damage to the underlying nerves. Symptoms suffered depend on where and to what degree the nerves are affected. They include: reduced or abnormal sensation, weakness, vision changes, clumsiness, sudden loss of bladder control and vertigo. Symptoms might appear in any combination and be mild or severe. They are usually experienced for unpredictable periods of time. These symptoms alone don't necessarily indicate MS and can easily be due to other unrelated conditions. The diagnosis is made based on the history, examination and a number of tests including an MRI and sometimes a lumbar puncture. Blood tests are also looking for other conditions that can mimic the same symptoms. There is no cure for MS but several treatments are available aimed at preventing attacks, improving symptoms and slowing progression. For more information visit www.msakl.org.nz

Multiple sclerosis is a progressive disease involving the brain and spinal cord.  It occurs over time in multiple sites in these two areas of the nervous system. The cause is not known but it is thought that a person’s immune system for some reason attacks the sheath that surrounds and protects nerves, causing inflammation, scarring and damage to the underlying nerves.
 
Symptoms suffered depend on where and to what degree the nerves are affected.  They include: reduced or abnormal sensation, weakness, vision changes, clumsiness, sudden loss of bladder control and vertigo. Symptoms might appear in any combination and be mild or severe. They are usually experienced for unpredictable periods of time.
These symptoms alone don't necessarily indicate MS and can easily be due to other unrelated conditions.
 
The diagnosis is made based on the history, examination and a number of tests including an MRI and sometimes a lumbar puncture. Blood tests are also looking for other conditions that can mimic the same symptoms.
 
There is no cure for MS but several treatments are available aimed at preventing attacks, improving symptoms and slowing progression. For more information visit www.msakl.org.nz 
Motor Neurone Disease (MND)

This refers to a group of progressive disorders where there is destruction of motor neurones (the nerves that control voluntary muscle activity such as speaking, walking, breathing, and swallowing.) Symptoms include: gradual weakening, shrinking of muscles and uncontrollable twitching of the muscles. Sensation, memory and personality are not affected. The diagnosis is made with the history examination findings, nerve conduction studies and electomyography tests. There are often other tests looking for other diseases to exclude before the diagnosis is confirmed. There is no cure or treatment for MND. Physical therapy, occupational therapy, and rehabilitation improve posture, prevent joint immobility, and slow muscle weakness and wasting. There are some medicines used to treat particular symptoms. The course of disease varies depending on the type of MND and the age of onset but it is progressive. For more information see http://mnda.org.nz/

This refers to a group of progressive disorders where there is destruction of motor neurones (the nerves that control voluntary muscle activity such as speaking, walking, breathing, and swallowing.)  Symptoms include: gradual weakening, shrinking of muscles and uncontrollable twitching of the muscles.  Sensation, memory and personality are not affected.
The diagnosis is made with the history examination findings, nerve conduction studies and electomyography tests.  There are often other tests looking for other diseases to exclude before the diagnosis is confirmed.

There is no cure or treatment for MND. Physical therapy, occupational therapy, and rehabilitation improve posture, prevent joint immobility, and slow muscle weakness and wasting. There are some medicines used to treat particular symptoms. The course of disease varies depending on the type of MND and the age of onset but it is progressive. For more information see http://mnda.org.nz/
 

Disability Assistance

Wheelchair access, Wheelchair accessible toilet, Mobility parking space

Additional Details

Face to face / Kanohi ki te Kanohi, Phone, Online / virtual / app, Speak with women / wahine, Speak with men / tane, Child / Tamariki friendly

Travel Directions

Travelling from South

  • Take the Market Rd exit and turn left
  • Right turn at lights into Great South Rd
  • Travel to main intersection of Manukau Rd & Great South Rd lights
  • Straight ahead into Alpers Ave (one way street)
  • Left turn into Gillies Ave
  • Drive approximately 750m along Gillies Ave
  • You will see us on the right-hand side of the road, almost opposite Southern Cross Gillies Ave Hospital

Travelling from North

  • Take the Gillies Ave exit
  • Turn right at the traffic lights, on to Gillies Ave
  • Drive approximately 1km along Gillies Ave
  • You will see us on the right-hand side of the road, almost opposite Southern Cross Gillies Ave Hospital

Public Transport

We recommend the Auckland Transport website

This website will provide you with information on the public transport available in your area as well as prices, timetables and a journey planner

Parking

There is parking available on site (including disabled)

Parking is also available on Gillies Ave between 9am-4pm

Pharmacy

find your nearest pharmacy here- https://healthpoint.co.nz/pharmacy/

Contact Details

183 Gillies Avenue
Epsom
Auckland 1023

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Street Address

183 Gillies Avenue
Epsom
Auckland 1023

Postal Address

183 Gillies Avenue, Epsom, 1023

This page was last updated at 1:16PM on August 29, 2024. This information is reviewed and edited by Auckland Medical Specialists (AMS) - Neurology Services.