Dandenong Neurology

phone (03) 9791 1599

location 136 David Street Dandenong, VIC 3175

car Parking available on site
Professional and friendly
medical staff  in comfortable
environment.

Dandenong Neurology & Specialists Group is a full service clinic specialising
in neurology, neuropsychology and geriatric services.

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Dandenong Neurology & Specialists Group is a comprehensive service clinic specialising in Neurology, Psychiatry, Neuropsychology and Geriatric services. Our professional team of highly skilled neurologists, specialists and therapists, diagnose and treat all types of neurological and psychological disorders with a focus on providing our patients with a higher quality of life.

Neurological Consultation

We understand that many patients are a bit apprehensive and anxious at the thought of having to make an appointment with a neurologist. You can be rest assured knowing that your care is extremely important to us and we will keep you informed every step of the way. Please be sure to review our patient information for details on what to bring to your neurological consultation.

Here is what you can expect during your neurological consultation:

Review of your medical history.

Review of your family medical history.

Determine if a neurological condition exists by neurological and medical examination.

Schedule tests and follow up appointments, if necessary.

 

Neurological Consultation

 

Will I need an MRI?

Your neurologist will schedule an MRI if they believe it will be helpful in ruling out certain neurological disorders. If you have had a CT scan or MRI scan recently, be sure to bring your old CT scan or MRI scan along with the report of the scan.

 

Will I need surgery?

There have been tremendous advances over the past twenty years in treating many neurological disorders. There are a variety of medications and alternative treatments now available that have taken the place of surgery.

If you need surgery you will be directly referred to the most competent Neurosurgeons on an urgent basis.

 

Physician Referrals

Dandenong Neurology & Specialists Group proudly accepts patients from referring physicians. If you’re a physician, please download and complete our physician referral form.

 

Click here or call (03) 9791 1599 to schedule an appointment with a neurologist.

Psychiatric Services

We provide following Psychiatric services with our Mental Health Experts-

  • Psychiatric assessment
  • Neuropsychology assessment
  • Medication management
  • Medico-legal reports
  • Psychotherapy
  • Second opinion
  • Work Cover
  • Tele-psychiatry

We understand that many patients are a bit apprehensive and anxious at the thought of having to make an appointment with a Psychiatrist. You can rest assured knowing that your care is extremely important to us and we will keep you informed every step of the way. Please be sure to review our patient information for details on what to bring to your psychiatric consultation.

Here is what you can expect during your Psychiatric consultation:

Review of your medical history.

Review of your family medical history.

Review of all your previous mental health assessments.

Schedule tests and follow up appointments, if necessary.

 

Neurological Consultation
There are so many new options available to patients that it can be difficult for patients to know which one, or which combinations, to choose. We believe it is important for patients to find a psychiatrist who has significant experience with the broad variety of treatment options available today.

We are devoted to providing quality comprehensive psychiatric services and delivering excellent high-quality health care. We take a balanced approach to go beyond symptoms relief and help you find ways to revitalise your life so that you can thrive in all of your endeavors. We also use Hypnotherapy, Psychotherapy and Mindfulness in a clinically appropriate scenario.

 

PHYSICIAN REFERRALS

Dandenong Neurology & Specialists Group proudly accepts patients from referring physicians. If you’re a physician, please download and complete our physician referral form.

 

Geriatric Services

As people grow older through the natural aging process they are often faced with a different set of medical challenges and impediments which are best handled by a geriatrician that is specially trained to provide medical care for mature adults.

Our geriatric services help individuals with a variety of issues including:

Chronic illnesses or multiple health conditions.

Memory-related disorders like Dementia and Alzheimer’s.

Problems with balance and gait.

Incontinence.

Difficulty sleeping.

Inability to carry out daily activities.

Behavioral or mood changes.

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Aged Care Physicians

Our geriatrician is a licensed aged care physician with many years of experience in providing a full range of specialized care for the benefit of older individuals. This includes physical as well as psychological assessment, nutritional plans and recommended social programs for those that require assistance with specific needs and tasks.

The goal of our geriatric services is to prevent and treat diseases and disabilities in older adults in an effort to promote better health that will provide a higher quality of life. Call (03) 9791 1599 to make an appointment with our geriatrician today.

Neuropsychological Assessment

Your primary physician may order a neuropsychological assessment to determine if a patient has any behavioral, cognitive or learning issues. A neuropsychological assessment is conducted in our comfortable clinic by a clinical neuropsychologist.

 

Neuropsychologist

Learning disabilities, Cognitive or behavioral issues are often misdiagnosed or ignored. Only a clinically trained neuropsychologist has the specialized training and skills to determine the specific problem and its remedy.

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Common learning disabilities include ADD, ADHD and Dyslexia. Cognitive problems encompass AAMI (age-associated memory impairment), Alzheimer disease, Lewy Body dementia, Frontal lobe disorders and Picks Disease.

Having a learning disability is nothing to be ashamed of. They have become increasingly common and can be controlled when properly treated. Through a series of tests, your neuropsychologist will first determine if a disability exists and if so the recommended course of treatment. These neuropsychological tests include memory games, puzzles and quizzes and are administered in a fun, relaxed and caring environment.

You can expect the assessment to take approximately 2 to 4 hours. Complimentary beverages are available. Call (03) 9791 1599 or schedule an online appointment today for your neuropsychology assessment.

Psychotherapy

What should I expect in therapy?

Sessions:

Many people avoid therapy because they feel it will involve extensive sessions of looking into the past and not managing immediate issues. Therapy deals primarily with the issues the individual brings, and what they would like support with. It is a client-centred approach, and typically involves 6-8 sessions (shorter or longer depending on client needs).

 

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The first session is an ‘initial assessment’ and during this session, individuals get a chance to tell their story. What brings them to therapy, what they would like support with, and what is their background (family, work, culture). This session is an opportunity for the psychologist to get an idea of the issues being faced within the context of your life.

During this session the client and psychologist will together set a therapeutic goal – what the individual would like to achieve/gain out of therapy. After this session, the psychologist is usually able to recommend what type of therapy would be suitable, and approximately how many sessions it will involve. All decisions are made collaboratively with the client.

Each session is typically 50-60 minutes long, beginning with a weekly check-in and ending with progress reviews.

 

What are the different types of therapy?

Cognitive Behavioural Therapy (CBT)

CBT is based on the assumption that thoughts, feelings, and behaviours are interlinked, and by changing one’s thinking, an individual can effectively change what they do/feel. Therefore, psychological issues, according to the CBT approach, is believed to be caused by distorted thinking, and restructuring these cognitions in therapy to more realistic and balanced thoughts is believed to improve behaviour and mood.

Beginning in childhood, individuals develop views about themselves and the world, and these feed the automatic thoughts that arise in their mind when perceiving any given situation. Thus all psychiatric disorders that CBT treats can be traced back to a negative core belief. CBT focusses on balancing these negatively biased beliefs and learning to manage the negative automatic thoughts that arise.

The aim of CBT is to assist clients in identifying cognitive distortions, and developing more positive ways of thinking/behaving. Dysfunctional cognitions are corrected over a series of short, structured, CBT sessions.
The CBT approach assumes distorted or negative thoughts precede a negative affect and behaviour, and CBT focuses on correcting the false self-beliefs that cause the client’s mental distress. Although medication can successfully treat up to two thirds of clients with depression, it has its downfalls—many clients don’t respond to medication or experience side effects, and individuals may prefer a non-medicated approach to therapy. CBT is an effective non-pharmacological treatment of mental disorders.

CBT involves psychoeducation, reframing core beliefs, and behavioural therapy to overcome initial inertia. Treatment sessions begin with the psychologist helping the client identify false negative interpretations of reality. These are then related to early life experiences/events that may have led to this cognitive distortion. Psychologists then work with clients to uncover evidence to prove to themselves whether this perception is true or false. Once identified as distorted thinking by the client, it becomes easier to reframe this cognitive dysfunction to a more positive way thinking. This is the cognitive aspect of CBT, and the behavioural aspect involves mood diaries and task journals. The behavioural dimension is included for the client to overcome their initial inertia and create positive reinforcements to lift energy and increase activities they engage in.

The behavioural aspect is often used throughout CBT, and involves the client documenting their daily activities, and moods during each. In this way, they are able to identify when they are feeling most low, and decrease those activities while increasing others. Task journals are also used to create ‘action plans’ on dealing with challenging situations – this will include the negative automatic thought they expect to have in that situation, and an alternative way they can think, along with an action of self-care to cope in that situation.

Since the first study published in 1977, the efficacy of CBT has been tested frequently, and there is a strong research background supporting the use of it in therapy for a variety of psychological disorders (depression, anxiety)

Acceptance and Commitment Therapy (ACT)

“The goal of ACT is to create a rich and meaningful life, while accepting the pain that inevitably goes with it.” – Dr Russ Harris

Fundamentally, the therapy encourages clients to accept what is out of their personal control, and commit to action that improves and enriches their lives. The purpose of ACT is to develop psychological flexibility in order to deal with external circumstances, find meaning and purpose in life based on values, and be open and mindful of the present moment. ACT aims to equip clients with skills to live a rich and meaningful life.

Mindfulness is a buzz word in Western psychology and is increasingly recognised as a powerful therapeutic intervention for everything from work stress to depression. ACT is essentially a mindfulness-based therapy, and facilitates the psychological processes of thought defusion, acceptance, and contact with the present. ACT works on the assumption that in a state of mindfulness, thoughts and feelings have less of an impact on an individual, and they are thus able to act in a way that is in line with their values and what is important to them. The all-encompassing approach makes ACT suitable for a range of disorders, and is a long-term approach to psychological wellbeing.

 

ACT uses six core principles to help clients develop psychological flexibility:

Defusion

Acceptance

Contact with the present moment

Observing Self

Values

Committed action.Defusion

Each principle has its own specific methodology, exercises, homework and metaphors.

therapy

ACT teaches clients how to alter the way difficult mental experiences impact an individual, rather than having to eliminate them from occurring at all. ACT is not about getting rid of bad feelings or getting over old trauma.
Essentially, ACT is summarised by Dr Russ Harris with

 

Essentially, ACT is summarised by Dr Russ Harris with

Embrace your demons, and follow your heart.
Dialectical Behaviour Therapy (DBT)

Founded by Marsha Linehan, DBT was initially developed for the treatment of patients with borderline personality disorder. Since then, the modality has evolved to treat a range of psychological issues. In DBT the psychologist assures the person that their behaviour and feelings are valid and understandable. Treatment then moves into recognising the personal responsibility of the individual, and the power they have in taking control of their behaviour.

The essential principles of DBT are that it is:

Support-oriented: Strengths-based, working on what the client is good at and improving their life through those channels

Cognitive-based: DBT identifies the internal processes that make external situations a problem, and helps to change thinking so that it is not so rigid and a more balanced view of reality is created.

Collaborative: Relationship based. DBT often involves exercises to develop new ways of interacting with others, and to manage difficult emotions independently. A large part of DBT is emotional regulation.

DBT is comprised of:
1. Mindfulness

2. Interpersonal Effectiveness – Focus is on response patterns. What are the individual’s patterns of responding to themselves and others? DBT skills training involve assertiveness and problem-solving – effective strategies for asking for what one needs, how to assertively say ‘no,’ and learning to cope with inevitable interpersonal conflict.

3. Distress Tolerance – Accepting, finding meaning for, and tolerating distress. Essentially, it teaches clients to bear pain in a helpful and psychologically healthy manner. The main survival strategies taught are distracting, self-soothing, improving the moment, and thinking of pros and cons.

4. Emotion Regulation – People with frequent experiences of mental distress typically have high levels of emotional intensity. Therefore, treatment involves learning how to manage the fluctuating emotions of the mind.

 

What is the role of a psychologist?

Psychology is the scientific study of the mind and human behaviour. A psychologist has undergone 5-6 years of University study and clinical training before becoming a fully registered practitioner. Psychologists use their knowledge to understand your specific needs and troubles and help you gain insight to your life. Through this understanding of unhelpful patterns of behaviour, change is planned in collaboration with the client, and the psychologist supports individuals during the process of implementing changes.

 

Who can benefit from therapy?

Any individual experiencing a level of mental distress can benefit from talk therapy. Common issues that therapy can address are:

Stress management

Overcoming fears/phobias

Low self-esteem/self-confidence

Clinically diagnosed mental disorders (depression, anxiety, bipolar)

Coping with grief

Understanding and reaching life goals

Making sense of past traumatic experiences

Difficulties with managing mood/emotion

Toxic/unhelpful relationships

Suicidal ideation and self-harm

Chronic pain

Managing/ending addictions such as alcohol, drugs, impulsive spending, sex…

Body image issues and eating disorders

Managing physical illness (e.g. terminal diagnoses)

Chronic fatigue

Specific to YOU

Despite the scientific study of psychology, therapy is essentially a humanistic approach to coping with mental distress. Each person experiences life differently, and as a result, coping with each experience needs to be catered to your individual needs. Therapy will shift and mould to fit your requirements.

The aim of therapy is to create a safe environment for you to reflect on your internal processes, develop insight, and grow from that awareness into action.

At Dandenong Neurology, we strive to provide a holistic approach to addressing issues and creating a meaningful life. Therapy can draw on both Western psychology and Eastern philosophies, and will equip you with skills to manage life situations. We are interested in a long-term approach to care, and the later therapy sessions will include resilience building and awareness exercises to allow clients to manage future situations independently.

 

Innovative approaches

The approach to therapy is open and holistic, and as a result we draw on a range of practices:

Meditation

Mindfulness

Yoga

Role plays

Use of mobile apps

Breathing techniques

Muscle relaxation

Guided visualisation

Introspective exercises – discovering values, developing awareness/insight, recognising purpose

Art

 

Medicare

(source: Australian Psychological Society)
https://www.psychology.org.au

To access mental health treatment under Medicare you must be referred by your GP, a psychiatrist or a paediatrician. If a GP is the referring practitioner, he or she will need to prepare a Mental Health Treatment Plan before referring you to a psychologist. You should book a longer session with your GP to enable time for this.

Medicare rebates are available for psychological treatment by registered psychologists under the Australian Government’s Better Access to Mental Health Care initiative. This scheme provides considerable assistance to people living with mental health problems, allowing them greater access to psychologists and providing more affordable mental healthcare.

Under this scheme, individuals diagnosed with a mental health disorder can access up to 10 individual and 10 group treatment sessions per year.

Referrals cannot be provided for the full 10 sessions. A referral is for a maximum of six sessions. Your referring doctor will assess your progress after the first six sessions and determine whether further sessions are needed.
After you have reached the maximum number of allowable sessions for the calendar year you will not be eligible for any further Medicare rebates for treatment you receive from a psychologist until the new calendar year.

Private Health Insurance
You cannot use your private health insurance ancillary cover to top up the Medicare rebates.

You need to decide if you will use Medicare or your private health insurance ancillary cover to pay for any psychological services you receive. That is, you can either access rebates from Medicare by following the claiming process or claim where available on your insurer’s ancillary benefits.

Speech Therapy

Speech issues are commonly seen in neurological disorders like multiple sclerosis, Parkinson’s disease, motor neuron disease, stroke, Myasthenia Gravis, Alzheimer’s disease and spasmodic dysphonia. These diseases can cause a number of other underlying problems like weakness or muscle spasms making it difficult for afflicted individuals to communicate.

We can help individuals with various kinds of speech and language disorders:

SpeechTherapy

Aphasia: The inability to form words, recall objects or complete sentences or speak spontaneously.

Dysarthria: Oral motor function is impaired and the muscles of lip, tongue, throat and cheek exhibit weakness. This causes speech to be unclear and incomprehensible.

Apraxia: A condition where coordination of speech is impaired. An individual will have difficulty piecing together syllables and sounds and is unable to use rhythm, stress and other common inflections of speech used to express meaning resulting in speech that may be monotone and unintelligible.

Dysphonia: Dysphonia is the medical term for disorders of the voice: an impairment in the ability to produce voice sounds using the vocal organs (it is distinct from dysarthria which signifies dysfunction in the muscles needed to produce speech). Thus, dysphonia is a phonation disorder. The dysphonic voice can be hoarse or excessively breathy, harsh, or rough, but some kind of phonation is still possible (contrasted with the more severe aphonia where phonation is impossible). Apart from voice therapy botulinum toxin injection can help. Please ask to book an appointment.

Our speech and language therapy services include diagnosis, evaluation and therapeutic intervention to develop, improve, correct and prevent the worsening of communication disorders. We will assess the quality, pitch and volume of the patient’s voice, provide patient education and offer tips for improving vocal skills. The speech therapist will also teach physiologic exercises to enhance the strength and quality of voice, and techniques to optimize speech.

Communication problems impair both comprehension and expression; thus directly influence the patients’ psychosocial well-being. Our speech therapy programs can markedly improve communication skills of patients with neurological disorders, thus helping to maintain optimal quality of life. Click here to schedule an appointment.

Nerve Conduction Study and EMG Test

What is a Nerve Conduction Study?

While reviewing a patient’s medical history and conducting a neurological consultation, the neurologist may determine that it is necessary to perform a Nerve Conduction Study (NCS). The procedure involves stimulating one or more nerves, with the help of metal electrodes placed on the skin, to measure and record nerve responses. The study provides valuable feedback regarding the number of nerve fibres present and the integrity of the myelin

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to conduct the nerve impulse. Depending upon the nerve, it can be either a motor nerve or sensory nerve conduction. The characteristics such as speed of the impulse, shape, wavelength and height of the nerve signal help the neurologist to diagnose whether the nerve is functional or defective.

An NCS is helpful in diagnosing conditions like carpal tunnel syndrome, muscle disorders, neuropathies, radiculopathy (nerve root damage), motor neuron diseases and disorders of the neuromuscular junction, such as myasthenia gravis.

 

What is an EMG (Electromyography) Test?

An electromyography (EMG) test is another diagnostic tool that our neurologists use that may be administered along with the nerve conduction study to measure the electrical activity of the patient’s muscles at rest and while contracting.

An EMG is routinely used to confirm or rule out abnormalities such as a lack of muscle response to electrical activity or even complete absence of contractions. Any inadequacy in nerve or muscle function can be easily detected with an EMG test. Apart from being used for diagnostic purposes, electromyography is also used to monitor our patient’s progress from prescribed treatments that are designed to improve muscular conditions.

EEG Test

While reviewing a patient’s medical history and conducting a neurological consultation, the neurologist may determine that it is necessary to perform an EEG test to measure brain wave activity. During the EEG testing, small metal discs or electrodes are briefly attached to the patient’s scalp. While the patient is relaxing, the EEG machine will listen as brain cells talk to each other through tiny signals called impulses. These impulses or brain wave activities are detected by the electrodes and transmitted across the wires to the EEG machine. The machine translates the electrical signals into patterns that are then viewed as a graph on the neurologist’s computer.

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Neurologists use EEG tests to diagnose brain disorders such as epilepsy, Alzheimer’s disease, sleep disorders (narcolepsy), altered behavior, unconscious spells, Brain tumors, Brain infections and head injury patients. It can also detect seizures caused as a result of stroke, which is one of the common causes of seizures in the elderly.

Abnormal results on an EEG test may indicate a seizure disorder or underlying brain dysfunction

The EEG test is a completely painless procedure and poses no significant health risks. However, there are certain conditions that may interfere with the reading of an EEG test. These include certain medications (sedatives), bright lights, low blood sugar levels during the test and body or eye movements during the procedure.

Please fax your referral to (03)9701 3036 to book an EEG appointment.

Migraine Clinic

Injection Treatment for Chronic Migraines

Since April 2014 Injection treatment for Chronic Migraine sufferers is on PBS for an eligible patient.

It is estimated that more than 10% of the Australian population suffers from migraine headaches resulting in lost time at work and enjoyment of extracurricular activities. A migraine is more than just a typical headache. It is an intense pounding and throbbing pain that steals one’s energy and ability to function during the duration of an episode which can last for one day or longer.

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While most conventional treatments involve taking medications that provide relief during the onset or aura of the acute symptoms, Antiwrinkle injections have been found to work as a preventive treatment for chronic migraine sufferers.

 

How does Antiwrinkle injection treatment work?

A migraine episode is triggered when the trigeminal nerve is stimulated, which releases neurotransmitters that cause painful inflammation of blood vessels of the brain. This inflammation causes symptoms of a severe headache, nausea, vomiting and sensitivity to light and sound. It works by blocking the release of those neurotransmitters that carry the pain signals through nerve impulses.

 

How is it administered?

Antiwrinkle injection is given in the form of low volume injections. These injections are administered by a trained Neurologist. It is injected across several specific head/neck muscle areas. The entire out-patient procedure takes around 15 minutes and the patient can resume their normal activities immediately following treatment. The recommended re-treatment schedule is every 12 weeks.

 

Are there any side effects of injection treatment for chronic headaches?

Temporary side effects such as muscle weakness, drooping of eyelids, neck pain, muscle pain, mild pain at the injection site and dry mouth have been reported by some patients. These side effects usually go away within few days without the need for any additional medication.

It is not recommended for individuals with existing neuromuscular disorders and heart conditions; or for women that are pregnant or nursing.

Voice Clinic

Our Voice Team:

Mr Malcolm Baxter (ENT surgeon) and A/Prof Sanjay Raghav(Neurologist) are doing Voice clinic for Spasmodic Dysphonia and similar disorders for more than 10 years.
 

What is Spasmodic Dysphonia?

Maybe you have heard someone whose voice sounds tight, strangled, broken, whispery, or otherwise “not quite right.” It may be your own voice or that of someone you know. You may be trying to determine what is wrong, or a doctor may have already diagnosed the condition as Spasmodic Dysphonia (SD) or Laryngeal Dystonia.

Neurological Consultation

Spasmodic dysphonia belongs to a family of neurological disorders called dystonias. A dystonia is a movement disorder that causes muscles to contract and spasm involuntarily. Dystonias can be generalized, affecting the entire body, or focal, affecting only a specific area of the body or group of muscles.

Following Parkinson’s disease and essential tremor, dystonia is the third most common movement disorder. The most common focal dystonia, cervical dystonia, causes the neck to twist or contort. Other dystonias can cause abnormal, involuntary blinking or spasm of the eyelids (blepharospasm), inappropriate contractions of the hand muscles (writer’s cramp), or uncontrolled movements from spasms in any of the muscles of the face, jaw, or tongue (oromandibular dystonia).

Certain dystonias, including SD, are task-specific, meaning that the muscles spasm only when they are used for particular actions and not when they are at rest. When a person with SD attempts to speak, involuntary spasms in the tiny muscles of the larynx cause the voice to break up, or sound strained, tight, strangled, breathy, or whispery. The spasms often interrupt the sound, squeezing the voice to nothing in the middle of a sentence, or dropping it to a whisper. However, during other activities, such as breathing and swallowing, the larynx functions normally.

Spasmodic dysphonia is estimated to affect approximately 10 Million people worldwide, but this number may be somewhat inaccurate due to ongoing misdiagnosis or undiagnosed cases of the disorder. Although it can start at any time during life, SD seems to begin more often when people are middle-aged. The disorder affects women more often than men. Onset is usually gradual with no obvious explanation. Symptoms usually occur in the absence of any structural abnormality of the larynx, such as nodules, polyps, carcinogens, or inflammation. People have described their symptoms as worsening over an approximate 18-month period and then remaining stable in severity from that point onward. Some people have reported brief periods of remission, however this is very rare and the symptoms usually return.

 

Diagnosis:

Diagnosing Spasmodic Dysphonia is difficult since the voice can vary significantly and the symptoms can present very similarly to other conditions such as Voice Tremor or Muscular Tension Dysphonia (a very common voice problem). This can lead to increased frustration and anxiety in the person with the condition and delays in accessing effective treatment. Initially you will be assessed by team of ENT surgeon, Mr Malcolm Baxter and Movement Disorder Specialist A/Prof Sanjay Raghav for Stroboscopy & neurological examination and then, if appropriate, for treatment with Botulinum toxin injections

 

Treatments:

Oral medications include benzodiazepines which act as muscle relaxants, anticholinergics and anti-epileptic drugs. These medications have been used with limited success.

Botulinum toxin remains the treatment of choice for most people with spasmodic dysphonia. Extremely small amounts of this widely used and clinically safe substance are injected into the affected laryngeal muscles, which reduces the overactivity of the muscles by weakening them.

It can provide significant (although temporary) relief from symptoms and marked improvement in voice quality. Botox acts by weakening the overactive muscles for approximately two to six months, after which further injections are needed throughout the person’s life.

There are possible initial side effects such as mild swallowing difficulties or a weak voice but for most it is well tolerated. Where the pharynx, palate and tongue are involved Botulinum toxin is not so successful.

In many cases, a trial of voice therapy with a speech pathologist is also offered prior to or with Botulinum toxin.

Surgery: there have been many surgical procedures performed for SD with varying success.

These include surgical separation of the vocal cords (thyroplasty) and various other procedures to cut part of the nervous supply to the muscles of the larynx.

A Speech Pathologist can assess the type of dysphonia and teach strategies to improve voice production and projection as well as giving advice on any swallowing difficulties.

Alternative therapies: if you are considering alternative therapies you should discuss them with your specialist beforehand to ensure they are not contraindicated in your condition.

 

Voice Tremor

Voice tremor is a neurological disorder that causes a regular wavering of the voice, not unlike an exaggerated singer’s vibrato, except that it occurs during speech as well as during singing. This disorder is one subtype of a neurological disorder called essential tremor, and it should be distinguished from another neurological disorder that sometimes includes a tremor component and consequent wavering in the voice laryngeal dystonia. Sometimes Botulinum toxin can help in this condition as well along with voice therapy.

Link for Spasmodic Dysphonia Video:

http://www.youtube.com/watch?v=KiUlZV6YDYM

Useful link:

https://www.dystonia.org.au/

http://www.dysphonia.org

Alternative Medicine for Neurological Disorders

Whilst there is no cure for many neurological disorders, therefore, the mainstay of treatment is symptomatic. Even when we have drugs to control some of the symptoms, they can have unpleasant side effects. In many cases, we are able to offer alternative medicine as adjuncts to conventional therapy. Many people don’t realize the enormous healing powers of one’s mind. By treating the mind and the body as a unit we have been able to improve the quality of life for patients suffering from debilitating neurological disorders.

Some of the alternative medicine therapies that we offer include:

 

Acupuncture

Acupuncture is especially effective in relieving neurological pain in cases of trigeminal neuralgia, sciatica, herpes zoster, multiple sclerosis and diabetic neuropathy. Neurological pain can be very intense and often does not respond well to some forms of medication for many patients. In such cases, acupuncture helps to relieve the discomfort by stimulating the release of several chemicals (neurotransmitters and opioids) from the brain which decrease pain sensitivity. It also causes the release of endorphins, which are the body’s ‘feel-good’ hormones, to reduce inflammation in the affected area. Reduction of pain by acupuncture increases function and quality of life of the patient and the healing effect of acupuncture slows the degenerative changes taking place in the nervous system. It may be quiet effective in chronic pain syndromes, fibromyalgia and chronic fatigue syndrome.

 

Ayurveda


Ayurveda is the traditional Indian medicine system, which encourages holistic health care by encompassing the physical, mental and emotional well being of the individual. There are a variety of Ayurveda treatments, including ‘Panchkarma’ therapy or five actions. This purification and detoxifying treatment, which includes massage and yoga, also use herbal medicines to eliminate accumulated toxins from the body. Ayurveda believes all neurological diseases to be a result of Vata dosha – which governs movement and activities of the nervous system in the body. Therefore, ayurvedic treatments for neurological diseases concentrate on correcting the Vata dosha in the body. Patients with Parkinson’s disease, Alzheimer’s disease, paralysis, epilepsy, migraine, multiple sclerosis and sleep disorders are given treatments like Ayurvedic massage, Shirodhara (pouring of medicated oil on the head), Thalam (dousing and retaining medicated oil on the head), herbs and ayurvedic internal medicines.

 

Yoga

Yoga is an ancient Indian science which deals with the union of self with the universal spirit. It has been used for more than 2500 yearrs to give physical and physiological health, mental peace, emotional equanimity and intellectual clarity to the practitioners on this path. It involves the performance of various asanas (yogic postures),  pranayama (modulation of breathing) and meditation.

The word Yoga is derived from the Sanskrit word, Yuj which shares its root with Yoke which means to join, allign or bind. Therefore it denotes the ultimate union of self with God. In Indian belief system, everything is permeated by the supreme universal spirit(God or Paramatma) of which the individual human spirit is a part(Jivatama). The system of Yoga is so called as it teaches the way by which Jivatama can unite to Parmatama and so gets liberated(Moksha).

Various traditions of yoga are found in Hinduism, Buddhism, Jainism and Sikhism. However, It was collated, coordinated and systematised by the sage Patanjali in his classical work Yog Sutras.

Hindu monks, beginning with Swami Vivekananda, brought yoga to the West in the late 19th century. In the 1980s, yoga became popular as a physical system of health exercises across the Western world. Many studies have tried to determine the effectiveness of yoga as a complementary intervention for various physical and mental disorders. In a national survey, long-term yoga practitioners in the United States reported musculo–skeletal and mental health improvements. The health benefits are the byproducts when a yogi is on the path of Yoga. However in western world Yoga is more or less used for a set of postures, exercises and relaxation techniques to improve physical and mental health.

We teach Yoga  in its true form as explained in Yoga Sutras which include postures, breathing exercises and meditation. Regular classes are held for people with various neurological disorders as well as healthy adults. We also run yoga classes in association with Parkinson’s Victoria from time to time for Parkinson’s Patients. Please ask our friendly staff about ongoing classes.

Regular practise of Yoga not only keeps you healthy but also brings peace and contentment to your life.

If you suffer from a neurological disorder, Schedule an appointment  to find out if you can benefit from alternative medicine for neurological disorders.

Injection Treatment for a Chronic Migraine

We understand that many patients are a bit apprehensive and anxious at the thought of having to make an appointment with a neurologist. You can rest assured knowing that your care is extremely important to us and we will keep you informed every step of the way. Please be sure to review our patient information for details on what to bring to your neurological consultation.

Since April 2014 Injection treatment for Chronic Migarine sufferers is on PBS for an eligible patient.

It is estimated that more than 10% of the Australian population suffer from migraine headaches resulting in lost time at work and enjoyment of extracurricular activities. A migraine is more than just a typical headache. It is an intense pounding and throbbing pain that steals one’s energy and ability to function during the duration of an episode which can last for one day or longer.

While most conventional treatments involve taking medications that provide relief during the onset or aura of the acute symptoms, Antiwrinkle injections has been found to work as a preventive treatment for chronic migraine sufferers.

How does Antiwrinkle injection treatment work?

A migraine episode is triggered when the trigeminal nerve is stimulated, which releases neurotransmitters that cause painful inflammation of blood vessels of the brain. This inflammation causes symptoms like a severe headache, nausea, vomiting and sensitivity to light and sound. It works by blocking the release of those neuro-transmitters that carry the pain signals through nerve impulses.

 

How is it administered?

Antiwrinkle injection is given in the form of low volume injections. These injections are administered by a trained Neurologist. It is injected across several specific head/neck muscle areas. The entire out-patient procedure takes around 15 minutes and the patient can resume their normal activities immediately following treatment. The recommended re-treatment schedule is every 12 weeks.

 

Are there any side effects of injection treatment for chronic headaches?

Temporary side effects such as muscle weakness, the dropping of eyelids, neck pain, muscle pain, mild pain at the injection site and dry mouth have been reported by some patients. These side effects usually go away within few days without the need for any additional medication.

It is not recommended for  individuals with existing neuromuscular disorders and heart conditions; or for women that are pregnant or nursing.

 

Hypnotherapy

WHAT IS HYPNOSIS/ HYPNOTHERAPY:

Hypnosis is a very natural, calm and relaxing experience that we can all enjoy and benefit from. The great advantage of Hypnotherapy is that it makes use of the trance state, a state that we are all very familiar with. Trance brings both your conscious and subconscious mind on board and focused on the same goal. We go in to and out of trance many times a day – when we’re driving to work, when we’re watching Television and even while you are reading this. In fact, we go in to a trance state when we are doing anything that requires our concentration. In a clinical setting a trance state is induced by a Hypnotherapist using guided imagery, stories, metaphors and suggestions which changes unwanted patterns of behaviour and puts you back in control of your life.

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HYPNOSIS IN NEUROLOGICAL DISORDERS:

Hypnotherapy has been found useful in various neurological disorders such as Parkinson’s Disease, Tics, Tourette Syndrome, Dystonia and Multiple Sclerosis. Some 30–80% of patients with chronic neurological disorders, such as multiple sclerosis and Parkinson’s disease, are reported to use Complimentary Alternative Medicine including Hypnotherapy. Two important aspects of hypnosis make it an interesting complementary treatment for patients with chronic neurological diseases: first, it takes individual wellness into account, and not only symptoms; and second, it empowers patients to take a more active role in their treatment.

 

PARKINSON DISEASE:

Hypnosis is used as an alternative therapy for Parkinson’s to reduce the tremor, anxiety, depression, pain, stiffness, libido and increase the quality of sleep and life of patients. There is emerging scientific evidence from Neuroimaging and EEG studies that mind can influence the body to balance the self-regulatory systems that control blood circulation, breathing and heart rate. Also, Hypnotic state is associated with modulation of various cortical areas of the brain, including the activation of sensory and motor cortical areas during perception and motor actions, but without external inputs or outputs; thereby indicating its potential usefulness in various movement disorders.

 

TICS AND TOURETTE SYNDROME:

Tics (vocal and motor) and Tourette syndrome are common childhood neurobiological disorders. Frontline treatment includes use of medicines; however, evidence and clinical experience support the use of self-regulation strategies including hypnosis and biofeedback as effective adjuncts or, in some cases, first-line treatments. The disorder has a significant impact on one’s functioning in several domains of life such as at home, school, and socialization. One aspect of TTS that can be very difficult for a child is that “my body is doing something that I don’t want it to do.” The need for self-control and self-management represents a strong developmental drive for all children. Techniques such as biofeedback and hypnosis can assist children by harnessing this innate developmental drive for mastery and autonomy and applying it for therapeutic benefit in the control of their TTS symptoms. Self-hypnosis also utilizes a child’s strong imagination and curiosity to facilitate tic regulation. By using biofeedback or hypnosis, children engage more actively in their own treatment process.

 

DYSTONIA:

Dystonia and particularly spasmodic torticollis are neuromuscular disorders that are extremely resistant to most therapies (physical, medical, or surgical). Torticollis is a unilateral spasm of the neck muscles, particularly of the sternocleidomastoid, that produces violent, tonic turning of the head to one side. The ethology remains uncertain, although the role of psychogenic factors has been emphasized. There are several case reports of spasmodic torticollis been treated successfully with hypnosis. The series ‘embarrassing bodies’ shown on Channel 4 showed the usefulness of Hypnotic techniques in management of dystonias.

 

HYPNOSIS IN MANAGEMENT OF PAIN:

Studies of hypnotherapy suggest a benefit for various types of pain, such as backache, surgery-related pain, cancer pain, dental procedure-related pain, burn pain, repetitive strain injury, facial pain, irritable bowel syndrome, tension headache, osteoarthritis pain and chronic pain. Use of hypnosis in management of pain associated with various disorders have been included in the 1995 consensus statement by the U.S. National Institutes of Health.

 

BIRTH/HYPNOBIRTHING:

Hypnotherapy in childbirth refers to the use of hypnotherapy to assist in the birthing process. This practice, known as hypnobirthing, functions on the premise that most labour-related pain is the result of fear and tension, which can be diminished or anecdotally eliminated with hypnotherapy.
The hypnotic suggestions can facilitate useful changes in perception and behaviour. Women can be guided into hypnosis by a practitioner during labour or individuals can learn self-hypnosis during pregnancy, for subsequent use during labour. This antenatal training is sometimes supplemented using an audio recording of hypnotic suggestions. For childbirth, hypnosis is often used to focus attention on feelings of comfort or numbness as well as to enhance women’s feelings of relaxation and sense of safety.

 

HYPNOSIS FOR WEIGHT MANAGEMENT:

Researches indicate that hypnosis is helpful in weight management especially when combined with a weight loss plan that includes nutrition and exercise.

 

HYPNOSIS IN MENTAL HEALTH ISSUES/DISORDERS:

ANXIETY AND ANXIETY DISORDERS:

Anxiety is a psychological and physiological state characterized by somatic, emotional, cognitive, and behavioural components. It is often accompanied by physical symptoms such as tremors, heaviness in chest, pain, tachycardia, sweat, headaches etc. Pathological anxiety appears when an individual overestimate the probability that a feared event (catastrophe) will occur, or the severity of the event when it does occur. There is a simultaneous underestimate of the coping resources and the likely rescue factors. The percentage of patients who present to psychotherapy to manage their anxiety is quite high and there is a good evidence to indicate that applying hypnosis and learning self-hypnosis allows the patients to reach a lower level of anxiety symptoms.

 

TRAUMA AND STRESS RELATED DISORDERS:

It is not uncommon for people who have experienced trauma or acute stress to dissociate from the painful memories and presenting to a psychiatrist or a psychologist with several psychological issues such as Post traumatic stress disorder (PTSD), Acute Stress Disorder or Dissociative or Conversion Disorders. Occasionally patients present to clinics with unexplainable physical symptoms. Dissociation is considered as a defense against both memories of the event and the experience itself. There is now upcoming research evidence to indicate that combination of hypnosis to unpack the hidden painful memories followed by positive suggestions and relaxation and other psychological techniques such as Cognitive Behaviour Therapy benefits patients significantly. One of the recent studies showed CBT-Hypnosis resulted in greater reduction in in reexperiencing symptoms at posttreatment than CBT.

 

HYPNOSIS/HYPNOTHERAPY IN ADDICTIONS:

SMOKING:

Hypnosis has been found helpful in several people in achieving their goal to quit smoking. The basic principle of hypnosis treatment for addiction is to bring those unhealthy thoughts to the surface and to replace them with more positive thoughts that encourage the smoker to cease leaning on something so dangerous to one’s health. Patients may be asked, under hypnosis, to share what they know that the unpleasant outcomes of smoking could be. The idea is to make the patient understand the three critical principles of quitting.
1. Smoking poisons the human body
2. The body is needed to live
3. Protect your body to the extent that you would prefer to live

The art of Self Hypnosis is also taught by the hypnotherapist to be practiced regularly to remain a non-smoker.

 

ALCOHOL & OTHER SUBSTANCES:

Hypnotherapy as an addiction treatment has gained credibility in the medical and psychiatric community. When performed by a qualified clinical hypnotherapist. It can help people in moving forward in their stage of change and relapse prevention. It works best for people who are in the rehabilitation process after their detoxification.
The hypnotic relaxed and suggestible state can help people to get a different perspective on their addictive behaviours. It modifies their pattern of thinking and helps people gain mastery and power to unpack themselves from long-term behavioural patterns that were previously inflexible and rigid.

Tele Video Consultation

Specialist video consultations under Medicare

People in telehealth eligible areas of Australia have access to specialist video consultations under Medicare. This provides many patients with easier access to specialists, without the time and expense involved in travelling to major cities.

We provide telehealth video consultation in Psychiatry, Neurology & Psychology.

Am I eligible for Tele Video Consultation?

Everyone is eligible; however, Medicare claims are only possible if you:

 

live outside a major city and are more than 15 km from the specialist

are not currently in the hospital.

People living in residential aged care facilities or receiving Aboriginal medical services anywhere in Australia are not affected by these restrictions.

A video consultation will only be offered if the specialist and GP consider it safe and suitable.

Excessive Sweating

What is Hyperhydrosis?

Hyperhidrosis is a condition characterized by abnormally increased sweating in excess of that required for regulation of body temperature Although primarily a physical burden, hyperhidrosis can deteriorate quality of life from a psychological, emotional, and social perspective It has been called by some ‘the silent handicap’.

Hyperhidrosis can either be generalized, or localized to specific parts of the body. Hands, feet, armpits, groin, and the facial area are among the most active regions of perspiration due to the high number of sweat glands (eccrine glands in particular) in these areas.

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When excessive sweating is localized (e.g. palms, soles, face, underarms, scalp) it is referred to as primary hyperhidrosis or focal hyperhidrosis. Excessive sweating involving the whole body is termed generalized hyperhidrosis or secondary hyperhidrosis. It is usually the result of some other, underlying condition.

Primary or focal hyperhidrosis may be further divided by the area affected, for instance palmoplantar hyperhidrosis (symptomatic sweating of only the hands or feet) or gustatory hyperhidrosis (sweating of the face or chest a few moments after eating certain foods.

The cause of primary hyperhidrosis is unknown, although some physicians who claim it is caused by over-activity of the sympathetic nervous system. Anxiety or excitement can exacerbate the condition for many sufferers. A common complaint of patients is they get nervous because they sweat, then sweat more because they are nervous. Other factors can play a role, including certain foods and drinks, nicotine, caffeine, and smells.

Injections of botulinum toxin type A can be used to block neural control of sweat glands. The effect can last from 3–9 months depending on the site of injections This use has been approved by the U.S. Food and Drug Administration (FDA) The duration of the beneficial effect in primary palmar hyperhidrosis has been found to increase with repetition of the injections The Botox injections tend to be painful. Various measures have been tried to minimize the pain, one of which is the application of ice.

BTX-A has since been approved for the treatment of severe primary axillary hyperhidrosis (excessive underarm sweating of unknown cause), which cannot be managed by topical agents

A microwave-based device has been tried for excessive underarm perspiration and appears to show promise.

Tap water Iontophoresis as a treatment for palmoplantar hyperhidrosis was originally described in the 1950s Studies showed positive results and good safety with tap water iontophoresis One trial found it decreased sweating by about 80%.