Neurology services
Neurology is the study of disorders of the nervous system and neurologists are specialist physicians that are expert in the diagnosis and treatment of all of conditions and diseases related to the central and peripheral nervous system and its connections. This includes nerve coverings, blood vessels and tissues, such as muscle. Many neurologists also have further training in subspecialty areas of neurology, such as stroke medicine, epilepsy, headache, multiple sclerosis, neuromuscular disorders, sleep medicine, pain management or movement disorders (Parkinson’s disease).
The San is one of only 20 hospitals in NSW and the only private hospital that is on the Ambulance NSW stroke matrix and identified as an approved Acute Thrombolytic Centre (ATC) for the treatment of patients suffering from stroke. To make this register, a hospital must have an emergency department and a 24/7 commitment to specialist care, treatment, medical imaging equipment and rehabilitation for stroke patients.
Conditions we treat
- Alzheimer’s disease
- Amyotrophic lateral sclerosis (ALS)
- Autonomic disorders
- Back or neck pain
- Behavioural neurology
- Carpal tunnel syndrome
- Cerebrovascular disease
- Clinical neurology
- Dementia
- Epilepsy
- Migraine and cluster headaches in adult and paediatric patients
- Movement disorders (Parkinson’s / Lewy body / Huntington’s diseases, and tremor dystonia)
- Multiple sclerosis
- Motor neurone disease
- Muscular dystrophy
- Neuropathic pain syndromes
- Neuromuscular disorders
- Neurophysiological diagnostic studies including EEG, NCV, EMG, and evoked potential testing
- Neuropsychology, including MCI, MMSE and comprehensive neuropsychological assessment
- Peripheral neuropathy
- Stroke – with 24/7 stroke care including TIA management and dissolving dangerous clots
- Tourette syndrome
- Vascular cognitive impairment
Parkinson's Disease
Deep Brain Stimulation (DBS) is an effective, long-term therapy for the management of Parkinson’s disease and other movement disorders. It is a specialised therapy and involves an expert multidisciplinary team including neurosurgeons, neurologists, psychiatry, and a DBS nurse specialist.
DBS therapy uses surgically implanted electrodes and a neurostimulator to deliver carefully controlled electrical stimulation to precisely targeted areas in the brain, thereby targeting specific patient symptoms.
A clinician programmer is used to adjust the stimulation to best control the individual's symptoms while minimising side effects. A patient programming device gives patients some control over their settings, within physician-prescribed limits.
Sydney Adventist Hospital is the fourth DBS centre in NSW and one of only two centres with a DBS nurse specialist.
Apomorphine is a potent dopamine agonist that works by mimicking the action of dopamine, making it a treatment option for Parkinson’s disease (PD). It comes in two forms, intermittent injections or a continuous infusion therapy.
Apomorphine Pen
Apomorphine injections are prescribed for people that have early motor fluctuations. It is administered via an injection and helps reduce motor fluctuations when oral Parkinson Disease medications wear off.
The Apomorphine pen will begin to work within 5 to 10 minutes after administration and effects generally wear off after 40 minutes. The usual frequency of dosing is between 3-5 time per day depending on the response. Apomorphine injections can be added to the usual PD regime.
Apomorphine infusion
Unlike the pen, apomorphine infusion slowly releases the drug via a pump subcutaneously which bypasses the digestive system. In most cases, the infusion is started in the morning and removed at bedtime. Therapy will allow for a dose reduction in oral levodopa by about 30-50% while other dopamine agonists will usually be ceased.
Duodopa is a gel form of levodopa that delivers duodopa directly into the jejunum or small intestine via a feeding tube. It is PBS covered and has been available in Australia since 2014.
Duodopa replaces all oral medications and delivers a continuous infusion for a maximum of 16 hours a day. It is commenced in the morning when the individual wakes up, and is disconnected at bedtime. In rare cases, the individual may be on a 24hr infusion for example, when they have severe nocturnal akinesia.
Duodopa is highly efficacious for motor symptoms and increases on time substantially. It is well tolerated once patients overcome the initial post operative period.
Diagnostic & Other Services
- Cerebral aneurysm and arteriovenous malformation management
- Diagnostic cerebral and spinal angiography
- Endovascular and cerebral aneurysm treatment
- Cerebral and Spinal Arteriovenous Fistula (AVFs) treatment
- Cerebral Arteriovenous Malformations (AVMs) treatment / clinical management
- Endovascular cerebral arteriovenous malformation (AVM) treatment
- Mechanical Thrombectomy (for Acute Stroke) with/without Carotid Stenting
- Spinal Intervention including Perineural, Epidural & Facet Joint Injections and Vertebroplasty