Dr Jacquie Deeb, consultant in clinical neurophysiology at Queen's Hospital, and Dr Alexis Hadjipourou, specialist registrar in clinical neurophysiology at St George’s Hospital and trainee representative, British Society for Clinical Neurophysiology, discuss the skills and expertise involved in the specialty, the training pathway, and how you can gain experience in clinical neurophysiology.
Introduction to clinical neurophysiology
Clinical neurophysiology uses measurements of electrical activity from the central and peripheral nervous system to help in the diagnosis and management of a wide range of neurological conditions. Clinical neurophysiology is an allied specialty to neurology and neuroscience in general. The neurological conditions diagnosed and managed by the specialty are wide, and across all age groups.
The specialty is small, with just over 100 consultants and 30 trainees across the UK. Departments are found in some district general hospitals but mostly in teaching hospitals or tertiary centres.
The practice is mainly outpatient based and consultant led, with considerable support from clinical physiologists, who have a technical background. The team is also made up of other members of the department, including secretarial and information technology staff, and healthcare assistants. The work is incredibly varied. In addition to outpatient work it includes a considerable amount of urgent inpatient, operating theatre, and intensive treatment unit work.
The neurophysiologist works in conjunction with the clinician in charge of a patient to define the most appropriate management of their condition. Dependent on the local needs and subspecialist interests of the medical staff, clinical neurophysiology may be used to monitor function during surgical operations on the brain, spinal cord and peripheral nerve. Clinical neurophysiologists may also carry out neurological clinics in relation to subspecialty interests – for example epilepsy and neuromuscular clinics.
Clinical neurophysiology resources
- For more information on the specialty, please visit The British Society for Clinical Neurophysiology.
- Consultant physicians working with patients – clinical neurophysiology chapter (p 67).
- Goebel A, Barker CH, Turner-Stokes L et al. Complex regional pain syndrome in adults: UK guidelines for diagnosis, referral and management in primary and secondary care. London: RCP, 2012.
- Clinical Medicine articles:
- Ratnarajah A, Barber B, Samarasinghe Y, Lloyd M. A young woman with myalgia. Clin Med 2014;14:525–7.
- Stanton B. The neurology of old age. Clin Med 2011;11:54–6.
- Petkar S, Bell W, Rice N et al. Initial experience with a rapid access blackouts triage clinic. Clin Med 2011;11:11–16.
- McCorry D, Cavanna A. New thoughts on first seizure. Clin Med 2010;10:395–8.
- McIntyre A. Career opportunities in the smaller medical specialties (editorial). Clin Med 2009;9:10–11.
- Parry S, Frearson R, Steen N et al. Evidence-based algorithms and the management of falls and syncope presenting to acute medical services. Clin Med 2008;8:157–162.
- Turner-Stokes L, Disler R, Williams H. The Rehabilitation Complexity Scale: a simple, practical tool to identify ‘complex specialised’ services in neurological rehabilitation. Clin Med 2007;7:593–9.
- Duncan J. Epilepsy surgery. Clin Med 2007;7:137–142.
- Petkar S, Jackson M, Fitzpatrick A. Management of blackouts and misdiagnosis of epilepsy and falls. Clin Med 2005;5:514–20.
- Halmagyi GM. Diagnosis and management of vertigo. Clin Med 2005;5:159–65.
Historical highlights from the library, archive and museum collections
From Alexander Hughes Bennett (1848–1901) to Anthony Martin Halliday (1926–2008), and pioneers and developments in between, read about clinical neurophysiology historical highlights on the RCP Library Archive and Museum Services blog.