Neurological expertise, from first history to final interpretation

Small sensors on the scalp record the brain’s electrical activity. It is the central test for seizures and epilepsy and is also used for blackouts and confusional states.

Duration: 30–40 minutes. Preparation: wash hair the night before, no oil or gel, eat normally, and bring a list of current medicines. Do not stop epilepsy medication unless told to.

An EEG performed after a deliberately shortened night’s sleep, which increases the chance of catching abnormal activity that a routine study misses.

Preparation: we will give exact instructions on how many hours of sleep to allow. Arrange for someone else to drive.

Brief electrical pulses measure how fast and how strongly signals travel along a nerve. Used for carpal tunnel syndrome, diabetic and other neuropathies, sciatica and unexplained weakness.

Duration: 30–45 minutes. Preparation: no cream or moisturiser on the arms or legs that day; keep the limbs warm on the way in.

A fine needle records electrical activity within the muscle, distinguishing nerve problems from muscle problems. Usually done in the same sitting as nerve conduction.

Note: tell us if you take blood thinners before the appointment.

Clicks played through headphones test the hearing pathway from ear to brainstem. It is the standard hearing test for infants and small children, and is used in adults for certain kinds of hearing loss and dizziness.

For children: the test is done during natural sleep, so we will plan the appointment around a nap and ask you to keep the child awake beforehand.

Measures conduction along the visual pathway from eye to brain. Used where optic nerve involvement is suspected — optic neuritis, multiple sclerosis and unexplained visual loss.

Preparation: bring spectacles or contact lenses if you use them.

Injections for chronic migraine, cervical dystonia, blepharospasm, hemifacial spasm and spasticity following stroke or in cerebral palsy. Benefit appears over several days and lasts around three months, so it is planned as a cycle.

Greater occipital nerve blocks and related injections for occipital neuralgia and chronic migraine. Takes a few minutes; where it works, relief is often noticeable the same day.

Cerebrospinal fluid sampling under local anaesthetic, for suspected nervous-system infection, demyelinating disease and certain headache syndromes. Aftercare instructions on lying flat and fluid intake are given in writing.

Structured assessment of memory complaints in adults, and of developmental delay, school difficulty and behavioural concerns in children — with a plan the family can actually act on.