Neurology Services

STROKE AND TIA

Vascular Disorders of the Central Nervous System include Stroke, Transient Ischaemic attack (TIA), Cerebral Small Vessel Disease, Vascular Dementia, Cerebral Amyloid Angiopathy among others. 

Theses diseases are very common with aging, and can be highly disabling. Accurate diagnosis and the right management plan are critical to ensure disability is either prevented or reduced. 

Dr Petre is an expert in Vascular Neurology having completed a Fellowship in this subspeciality at the Cambridge University Hospital, and is also a Member of the Australasian Stroke Academy. 

He offers a rapid access services for suspected TIA. He uses the latest diagnostic tests including access to prolonged cardiac monitoring using HeartBug.

Migraine and Headache

Migraine is more than just a “bad headache” — it is a neurological condition. It is very common and if untreated, can impact significantly on employment and education. 



Accurate diagnosis is important, but in the case of typical symptoms, is generally straightforward. 

The management options for migraine have expanded greatly in recent years, with several highly effective injectable treatment options now covered by the Pharmaceutical Benefits Scheme (PBS). 

Dr Petre offers a comprehensive service for both the diagnosis and management of Migraine. His approach emphasises both the lifestyle and medication options for migraine management, tailored to the individual and their preferences. He offers the latest injectable treatments, including Botulinum toxin, CGRP antagonists and nerve blocks. 

Dr Petre also has an interest in other headache disorders, including the management of Cluster Headache and Trigeminal Neuralgia.

Peripheral Neuropathy 

Peripheral neuropathy is a condition that occurs when the peripheral nerves—the nerves outside the brain and spinal cord—are damaged. These nerves carry messages between the brain, spinal cord, and the rest of the body. When they are damaged, communication is disrupted, which most commonly affects sensation, but can also affect movement, balance and rarely, organ function. Pain is also a common issue. 

Peripheral neuropathy is a very general term which covers a wide variety of disorders of the peripheral nervous system.

The causes of Peripheral Neuropathy are numerous and as such, the diagnostic evaluation is tailored to the individual based on their history, examination findings and electrodiagnostic assessment (Nerve Conduction Studies and Electromyography). 

Dr Petre performs Nerve Conduction Studies and Electromyography in his rooms using the latest Natus technology. These diagnostic tests are essential to define most disorders of the Peripheral Nervous System. 

Some of Peripheral Nervous System disorders which Dr Petre treats include: 

• Compressive mononeuropathies (e.g. carpal tunnel syndrome, ulnar neuropathy, peroneal neuropathy etc) 
• Cervical and lumbar radiculopathy (nerve root compression) 
• Acquired Polyneuropathies (e.g. diabetic, B12 deficiency etc)
• Chronic Inflammatory Demyelinating Polyneuropathy (CIDP)
• Hereditary Polyneuropathies (e.g. Charcot Marie Tooth)
• In addition to many others
  

MULTIPLE SCLEROSIS

MS is the most common acquired chronic neurological disease affecting young adults, often diagnosed between the ages of 20 to 40 and, in Australia, affects three times more women than men. There is no cure, but many highly effective disease modifying treatments are available. 

There is no known single cause of MS, but many genetic and environmental factors have been shown to contribute to its development.

In MS, the body’s own immune system mistakenly attacks and damages the fatty material – called myelin – around the nerves. Myelin is important for protecting and insulating nerves so that the electrical messages that the brain sends to the rest of the body, travel quickly and efficiently. As the myelin breaks down during a MS attack – a process called demyelination – patches of nerves become exposed and then scarred, which render the nerves unable to communicate messages properly and at risk of subsequent degeneration. 

Dr Petre offers an expert approach to both the diagnosis and management of MS. He uses the modern neuroimaging techniques to enhance diagnostic accuracy and moitor progression. He offers most of the latest high efficacy injectable treatments, including Natalizumab (Tysabri) and Ofatumumab (Kesimpta), which are kept in stock at both the Capalaba and Camp Hill sites.

Parkinson’s Disease, Tremor and Movement Disorders

Parkinson’s disease (PD) is a long-term neurological condition that affects movement. It happens when certain brain cells that make dopamine (a chemical that helps control movement) stop working properly or die. The exact cause is not known, but is likely to be a combination of age, genetics and environmental risks factors.

 

Although Parkinson’s Disease is a long-term condition, many people live full, active lives for years with the right treatment and support.

There is no one diagnostic test to confirm Parkinson’s Disease, and there are a number of conditions (e.g. atypical Parkinsonism) that can present in a similar way. Diagnosis is based on a combination of the patient history, examination findings, selected investigations and in some cases, response to treatment. 

Dr Petre works with his Neuroradiology colleagues to offer the latest diagnostic tests, including F-DOPA PET scan. 

He will create and individual management plan for both the motor (movement) and non-motor symptoms of Parkinson’s Disease. This will often involve lifestyle options, medications and a multidisciplinary team including a physiotherapist, speech pathologist and occupation therapist. 

Sometimes, as Parkinson’s Disease progresses, medications are no longer able to achieve adequate symptoms control, and more invasive treatments such as Deep Brain Stimulation may be required. Dr Petre works closely with colleagues that offer such advanced treatment options. 

Dr Petre also regularly sees patients with other causes of Tremor, such as Essential Tremor and Dystonic Tremor. 

He manages patients with other movements disorders such as Dystonia (including Cervical Dystonia), Ataxia and Chorea. 

Dr Petre performs Botox injections at both Capalaba and Camp Hill for cervical dystonia.

Neuro-Ophthalmic Disorders

Dr Petre manages Neuro-Ophthalmic Disorders including Idiopathic Intracranial Hypertension (IIH), Optic Neuritis, Double Vision (Diplopia) among other conditions. 

He works closely with colleagues in Ophthalmology (Eye Surgery) to provide access to important diagnostic investigations such as Computerised Visual Fields and Optical Coherence Tomography.

Seizures and Epilepsy

Epilepsy is a neurological condition that causes repeated seizures without a recognised provoking factor. A seizure happens when there is sudden, abnormal electrical activity in the brain.

Having one seizure does not always mean epilepsy. Epilepsy is diagnosed when a person has two or more unprovoked seizures, or a single seizure in the presence of a structural brain abnormality, abnormal electroencephalogram (EEG) or epilepsy syndrome. 

Seizures can look very different from one person to another, depending on where the seizure starts in the brain, and how it spreads. 

• Focal seizures – start in one part of the brain
• May cause staring, unusual movements, or strange feelings
• Awareness may be either preserved or impaired 
• Generalized seizures – involve both sides of the brain
• Tonic-clonic seizures: loss of consciousness, stiffening, shaking
• Absence seizures: brief staring spells, often in children
• Myoclonic seizures: sudden jerks of arms or legs

There are many different causes of epilepsy, including traumatic brain injuries, stroke, brain tumours, brain infections and genetic causes. In some people no definitive cause is found. 

There is no one test to confirm the diagnosis of epilepsy. Dr Petre will use a combination of your history, examination findings, EEG, Brain MRI and in some cases blood tests. 

Treatment is tailored to the individual, and in most cases will involve antiseizure medications. In some cases more advanced treatment options may be recommended. 

Seizures and epilepsy will often impact ability to drive. Dr Petre follows the AustRoads guidelines, but will work with patients to minimise the impact of driving restrictions where possible.

Neuro-Muscular Disorders

Neuromuscular disorders are conditions that affect the nerves, muscles, or the connection between them (the neuromuscular junction). These problems make it hard for muscles to work normally, leading to weakness, fatigue, or loss of muscle control.

Neuromuscular disorders may involve:

• Motor nerves (carry signals from brain to muscles)
• Muscles
• Neuromuscular junction (where nerves connect to muscles)
• Spinal cord (in some conditions)

Examples of neuromuscular disorders; 

• Muscular dystrophies
• Myasthenia gravis
• Motor neuron disease (ALS and others)
• Peripheral neuropathies
• Inflammatory muscle diseases (myositis)

The causes of these conditions are high varied, and may be genetic or acquired. Acquired causes span the breadth of autoimmune, infectious, inflammatory and metabolic / toxic causes. 

Diagnosis involves a combination of history, examination, blood tests, nerve condition studies/electromyography and neuroimaging. 

Treatment is tailored to the specific condition, and will almost always involve a multidisciplinary team. 

COGNITIVE DISORDERS

Cognitive disorders affect a person’s ability to think, remember, learn, reason, or make decisions. These changes are caused by problems in the brain and are not a normal part of aging.

Dr Petre is happy to assess patients with suspected cognitive disorders, particularly those with a young onset (<65 years old). 

Common types of cognitive disorders include:

• Mild Cognitive Impairment (MCI) – mild changes, daily activities mostly intact
• Dementia (major cognitive disorder), including:
• Alzheimer’s disease
• Vascular dementia
• Lewy body dementia
• Frontotemporal dementia
• Cognitive impairment after stroke or brain injury
• Cognitive problems related to Parkinson’s disease or other neurological conditions

Dr Petre performs in-room cognitive testing, in addition to advanced neuroimaging, and links with a multidisciplinary team or other specialists to assist with management.