Neurologist in Brighton

Neurology is the study of the nervous system. A neurologist is a medical doctor with physician specialist training in the diagnosis and treatment of conditions related to the brain, spinal cord and nervous system.

Associate Professor Lynette Kiers is a consultant neurologist and the Director of Clinical Neurophysiology at the Royal Melbourne Hospital (RMH). After completing her medical degree and neurology training at the University of Melbourne and Royal Melbourne Hospital, Lyn embarked upon postgraduate training and research in neurophysiology at the Mayo Clinic and Massachusetts General Hospital, USA. Lyn is one of two neurologists managing the botulinum toxin clinic at RMH for the treatment of neurologic disorders. In addition to expertise in clinical neurophysiology for diagnosis of peripheral nerve pathology, she has over 10 years’ experience with injections for a range of neurologic diseases including hemifacial spasm, blepharospasm, cervical dystonia, dystonic tremor, spasticity, axillary hyperhydrosis and chronic migraine. Treatment for the above conditions is funded under the pharmaceutical benefits scheme for patients meeting specific criteria.

Injection Therapy for Chronic Migraine, Excessive Sweating (HYPERHIDROSIS) and Involuntary Movements

Pain relieving, muscle relaxant injections (often used to smooth facial wrinkles) are indicated for a range of neurologic diseases, including spasmodic torticollis, dystonia, blepharospasm, hemifacial spasm, and chronic migraine. Injections of this medication can also be used to treat primary axillary hyperhidrosis (severe underarm sweating).

A clinical consultation is required to determine if your condition is likely to respond to injection therapy (“anti-wrinkle” muscle relaxant with ultrafine needles). Following consultation, and if eligible, you will be given detailed information about the procedure and any potential side effects. For particular conditions, muscles to be injected will be identified using electromyography (EMG) which records muscle activity.

Neurological conditions currently treated by injectable medication at Brighton Spine and Sports Clinic are as follows:

• Blepharospasm
• Cervical dystonia (spasmodic torticollis)
• Chronic migraine
• Dystonic tremor
• Hemifacial spasm
• Primary axillary hyperhidrosis (excessive underarm sweating)
• Spasticity

Detailed information can be found at:

www.headacheaustralia.org.au (chronic migraine)
www.bebaustralia.org.au (blepharospasm)
www.mydr.com.au/skin-hair/hyperhidrosis-excessive-sweating (excessive underam sweating)

Nerve Conduction Testing and EMG

Nerve Conduction Studies (NCS) are a diagnostic test used to evaluate the peripheral nerves and muscles. It can be helpful in evaluating weakness, muscle pain, numbness, and pins and needles. Common conditions referred for NCS include carpal tunnel syndrome, ulnar neuropathy and peripheral neuropathy. Sometimes Electromyography(EMG) will also be required, such as for evaluation of spinal nerve root compression, muscle disease, and acute traumatic nerve injuries.

Nerve conduction studies involve stimulating the nerves on the surface of the skin and recording from either nerves or muscles. This causes a tingling/throbbing/tapping sensation and may cause the muscle to twitch. There are no side effects or after-effects and most patients find the test to be only mildly uncomfortable. If EMG is required, a fine disposable needle will be inserted into several muscles and recordings of the muscle activity is made. This is not required in most cases but may be indicated for investigation of muscle disease, and also for some generalized or focal nerve disorders. Rarely this results in a bruise or small haematoma (collection of blood) at the site of needle insertion, which will resolve spontaneously. Please advise Dr. Kiers if you are on blood thinning medication.

Dr. Kiers will issue a report at the end of the test. This should be taken back to your referring doctor for further discussion regarding diagnosis and treatment.