Mae'r fersiwn Gymraeg yn y broses o gael ei chyfieithu/The Welsh version is in the process of being translated

Private Consultant Neurologist

Private Consultant Neurologist

Brython Hywel

I am a consultant neurologist and clinical neurophysiologist living in Llanrug in north Wales. I am employed by the Walton Centre NHS Foundation Trust in Liverpool. My NHS role is spread between Walton and Ysbyty Gwynedd in North Wales (The Walton Centre provides neurology services to Betsi Cadwaladr Health Board). 3 days per week are in Walton, where I provide nerve conduction and EMG (electromyography) clinics as well as report EEG (electroencephalography) and EP (evoked potential tests). On one morning per week I do a general neurology clinic in Ysbyty Gwynedd, and on another morning I see neurology ward referrals.

Nerve conduction studies and electromyography are an extension of the neurological examination. They help with the diagnosis of nerve and muscle diseases. For nerve conduction studies, small electrical impulses are passed through nerves and the responses are picked up and analysed to assess how well the nerves are working. Electromyography involves a needle being inserted into muscle whilst connected to the nerve conduction machine. The inherent electrical signal within the muscle is analysed. It can give detail as to how well the nerve supply to that muscle is working and can give clues to whether the underlying problem is within the muscle itself (myopathy). In general, the consultation involves history and examination followed by the nerve conduction tests then EMG. A report is provided to the referring clinician.

Common conditions that these tests can look for include:

  1. Carpal tunnel compression. This is where the median nerve that runs through the centre of the wrist can be compressed in the narrow canal formed by the wrist. Nerve conduction tests can help prove the presence of carpal tunnel compression and grade its severity from very mild to extremely severe. This can help target appropriate treatment.
  2. Ulnar neuropathy at the elbow. This is where the ulnar nerve, that supplies sensation to the little finger and half of the ring finger, is irritated as it passes around the elbow. This is the nerve that is irritated when we hit our funny bone. Identifying ulnar neuropathy at the elbow can lead to treatment which ranges from conservative measures to protect the nerve, such as taking care not to apply too much pressure to the nerve, to operations to protect the nerve (decompression or transposition). Nerve conduction studies can help differentiate ulnar neuropathy at the elbow from ulnar neuropathy at the wrist, which is less common.
  3. Radiculopathy. This is where the nerve roots are irritated as they leave the spinal canal, most commonly by spinal discs that have moved due to wear and tear. Nerve conduction tests and EMG can help show that nerve symptoms in the limbs are due to radiculopathies leading referrers to targeted imaging such as MRIs of the spine.
  4. Peripheral polyneuropathy neuropathy. Peripheral polyneuropathy is a process that affects the functioning many of the peripheral nerves. There are many different forms and causes, including low B12, diabetes, high alcohol intake, and infections such as HIV. There are a substantial number of people with genetic polyneuropathies, and whilst many are diagnosed in childhood there are cases picked up in adulthood. In many cases of polyneuropathy, the exact cause isn’t found.
  5. Mononeuritis multiplex. This is where more than one nerve, not connected to each other, are affected. It can be caused by an inflammation of the blood vessels (vasculitis). This is rare, but important not to miss as it can be treatable and early treatment can reduce disability.
  6. Motor Neurone Disease. Also known as Anterior Horn Cell Disease, this is a disease where the motor nerves, that tell the muscles when to move, degenerate. It is a degenerative disease. EMG can help diagnose this condition, to aid management.

from our patients

I First met Dr. Tim Clayton when he treated our 2 year old grandaughter a couple of years ago and improved her skin condition immensely. Since then I have been treated by him for actinic keratosis on my face caused by sun damage over many years. His advice and treatment have been exceptional and have resulted in my condition improving dramatically. I would have no hesitation in recommending him and, in fact, have done so to numerous friends!

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Ty Gwair, Llanwnda, Caernarfon LL54 5SD.

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01286 238477

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