My Experience & Expertise
I have been a Consultant Neurologist in Sussex for over 18 years. I have a broad range of neurological interest & experience. I have particular expertise in Sleep Disorders, Parkinson’s Disease, Movement Disorders, Epilepsy, Multiple Sclerosis, immune-mediated neurological conditions and HIV-Neurology.
My Clinical Style
My practice (both NHS & Private) is focused on providing opinions and management advice plans on un-selected new patient referrals. My interests and experience span the full range of neurological conditions and many areas of neuroscience. The core of my practice centres on making accurate diagnoses before the results of investigations are available, organizing investigations in a timely fashion and giving my patients a clear and reassuring explanation of their symptoms and disorder
My Neurology Practice
I diagnose and treat disorders of the brain (eg Parkinson’s disease, Epilepsy, encephalitis, cerebellar ataxia and dystonia), disorders of the spinal cord (eg cervical myelopathy, syringomyelia), disorders of the peripheral nerves and nerve roots (eg lumbar nerve root entrapment, peripheral neuropathy), disorders of multiple parts of the nervous system (multiple sclerosis, motor neurone disease, sub-acute combined degeneration, and disorders of muscle and the neuro-muscular junction (polymyositis, muscular dystrophies and myasthenia gravis).
My Sleep Practice
I diagnose disorders of sleep including sleep apnoea, sleep walking, REM sleep behaviour disorder, circadian rhythm disorders, narcolepsy and primary hypersomnolence. I have an Honorary contract with the QVH NHS Foundation Trust Sleep Disorders Centre, East Grinstead, where I have run a Sleep Neurology Clinic and a full poly-somnographic (PSG) sleep study service.
My Dystonia & Spasticity Practice
I have been injecting botulinum toxin into muscles to treat dystonia and other movement disorders for over 20 years. I have previously run an EMG-Guided Botulinum Toxin Clinic for Movement Disorders at Hurstwood Park Neurological Centre.
Working with Hospital Colleagues
I have close working relationships with neuro-surgeons, neuro-psychologists, neuro-physiologists, specialist nurses and neuro-physiotherapists. When appropriate, I refer patients to these colleagues. I have always had good relationships with junior medical staff, nursing staff and colleagues.
Working with GPs
I have always believed in sharing care of patients with GP colleagues, although I believe in keeping this relationship flexible, rather than constraining it into rigid protocols. With the advent of new GP-led commissioning groups, I believe there are new opportunities for GPs to work alongside neurologists in trying to develop services in line with the National Service Framework on long-term conditions and get patients diagnosed and treated closer to home.
My Medico-Legal Practice
I have an interest in defining the neurological impairment in a given case and estimating its effects on client’s actions and abilities and its socio-economic impact upon the client’s life.
Notable Example cases:
I have been a principal expert witness in 2 murder trials, one in which manslaughter was accepted in a case of a man who killed while in a state of dissociative amnesia. The second case was another case of accepted manslaughter in a patient with Huntington’s Disease who took his wife’s life. I was also principal expert witness in a case where of a man who ran over a pedestrian while having a cerebro-vascular event and was convicted for death by dangerous driving after failing to disclose his history of previous TIAs on his driving license renewal application.
Sleep Medicine & The Law
I gave expert evidence in court in the case of an elderly lady prosecuted for causing death by dangerous driving after allegedly falling asleep at the wheel. Fortunately for her, she was found not-guilty
I regularly provide expert evidence in cases where brain, spinal or nerve injury is alleged. I provided evidence for a severe whiplash injury with spinal cord contusion triggering relapsing inflammatory myelitis at the site of the contusion in a woman with handicapped children. The case was settled out of court for a significant sum of money.
1. My medical evidence at an Employment Tribunal and a subsequent Appeal was the principal supporting evidence that led to the Tribunal’s finding and subsequent upholding of the finding that a University had discriminated against an employee, contrary to the provisions of section 5 (1) and (2) of the Disability Discrimination Act 1995 (“the Act”), by making it impossible for the Applicant to return to work by its failure to make reasonable adjustments. (http://www.employmentappeals.gov.uk/Public/Upload/EAT74702962003.doc )
The case has been cited Oxford Centre for Higher Education Policy Studies as a teaching case (Peterssen v University of Brighton, ET 2003, Index of cases Part 8, Online Casebook http://oxcheps.new.ox.ac.uk/new/casebook/ )
2. I provided evidence of the failure of a large company to comply with disability discrimination legislation in the case of a man with Sjogren-Larsen Syndrome. The case was settled out of court for a large (undisclosed) sum.
Medical Insurance Practice
I have been a Neurology CMO to the insurance industry since 2008 and currently provide neurological advice to teams of underwriters and claims assessors in a large direct insurance company and a large re-insurance company. This work has a particular emphasis on prognosis.