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Epilepsy Surgery - Northern Children's Epilepsy Surgery Service (NorCESS)

Beth-PooleThe NorCESS team is made up of staff from both Alder Hey and Royal Manchester Children’s Hospital (CMFT).


Dr Martland -Clinical Lead, Rachel Kneen, Jeen Tan, Anand Iyer


Ms Sasha Burn, Mr Vivek Josan


Sarah Doyle, Teresa Preston, Alison Sudlow, Tamarin Foy, Brian Tedman


Stewart Rust, Vicky Gray, Rebecca Bromley


Dr Lakshmi Ramasubramanian, Dr Hilary Lloyd


Dr Shivaram Avula, Dr Stavros Stivaros


Andrea McLaren, Ben Cooper, Kay Hall

Epilepsy Surgery Coordinator

Emily Tolno


Dr Tim Martland – Clinical Lead
Copy of Tim Martland 1Tim Martland is Consultant Paediatric neurologist at Royal Manchester Childrens Hospital and Lead Clinician for NorCESS. He graduated from Edinburgh University in 1986 and after jobs in Scotland and London, trained in neurology in Newcastle, Nottingham, Sheffield and Los Angeles before taking up his current post in 1998.

He is the lead for complex epilepsy for the North West region and has, with colleagues, established services for ketogenic diet and vagal nerve stimulation, as well as for epilepsy surgery, in Manchester. He has been chair of the British Paediatric Epilepsy group and chair of the Neurosciences group of the Medicines For Children Research Network.

Research interests include new drug treatments for epilepsy and the treatment of status epilepticus. He developed the national status treatment guidelines in 2000 with Dr Appleton.
When not at work he can be found orienteering and fell running around the Lake District.

Rachel Kneen
rkneenDr Rachel Kneen is a Paediatric Neurologist who has a clinical interest in epilepsy, particularly management with the ketogenic diet (she is the clinical lead for this service).

This service has developed rapidly over the last three years and patients are now being treated from the Merseyside and other regions of the country. She also has a clinical interest in Neurovascular disorders and works as a member of the Neurovascular Multidisciplinary Team. In 2011 she established a new clinical service to develop and improve the management of children with Neuroinflammatory disorders with Dr Eileen Baildam from the Rheumatology Team. This service is managing children with a wide range of autoimmune neurological disorders including those with autoimmune encephalitis.

She is an honorary member of the Liverpool Brain Infections Group and an Associate Member of the Institute of Infection and Global Health ( and has a clinical and research interest in paediatric brain infections. She is particularly interested in improving the management of children with suspected or proven brain infections, particularly those with viral encephalitis. She is a medical advisor to the Encephalitis Society. As part of her links with the Liverpool Brain Infections Group, she established the annual Liverpool Neuroinfectious Diseases course with three other colleagues in 2008.

Qualifications: B Med Sci in Immunology 1989 from the University of Nottingham, BM, BS 1991 from the University of Nottingham, DCH 1993, MRCPCH 1994

Current Memberships: RCPCH, British Paediatric Neurology Association

Department and Specialities

Consultant Paediatric Neurologist at Alder Hey Children’s Hospital. Honorary Senior Lecturer, Institute of Infection and Global Health, University of Liverpool. Member Liverpool Brain infections group

Clinical Interests

  • Central Nervous System Infection and Inflammatory disorders, particularly encephalitis.
  • Epilepsy, particularly the Ketogenic Diet
  • Neurovascular disorders

Research Interests

Rachel has a research interest in brain infections, particularly viral encephalitis.
She is also the Principal Investigator at Alder Hey for several other portfolio studies including the Paediatric UK Demyelinating Disease Longitudinal Study (PUDDLS), the International Collaborative Infantile Spasms Study (ICISS) and the Vascular Effects of Infection in Pediatric Stroke Study (VIPS).
Additional Information

Jeen Tan

Dr Jeen TanJeen is a Consultant Paediatric Neurologist at Royal Manchester Children’s Hospital. She obtained her undergraduate degree at Sheffield University, and trained in paediatrics in Sheffield, Birmingham, and Manchester, where she completed her training in paediatric neurology. This was followed by a 1 year-fellowship in complex epilepsy at Great Ormond Street Hospital for Children. She gained skills and experience in epilepsy surgery evaluation and the management of complex epilepsy.

Apart from assessing patients for epilepsy surgery, she is the clinical lead for the ketogenic diet service in Manchester and manages patients with a range of neurological conditions. She supervises undergraduate student projects and teaches doctors and other health care professionals in the BPNA paediatric epilepsy courses.

Anand Iyer

Copy of Anand Iyer 2Anand is a consultant paediatric neurologist and epileptologist at Alder Hey Children’s Hospital. After completing his postgraduate training in Paediatrics in India, he completed his higher specialty training in paediatrics and paediatric neurology from the Fraser of Allander Neurosciences Unit, Yorkhill Children’s Hospital, Glasgow; Birmingham Children’s Hospital, Birmingham and Alder Hey Children’s Hospital, Liverpool.

Anand has a particular interest in clinical neurophysiology related to invasive monitoring and cortical functional mapping for epilepsy surgery for which he recently undertook a period of observership at the Hospital for Sick Children, Toronto, Canada. Apart from epilepsy, he is interested in paediatric neuroimmunology – specifically childhood demyelinating disorders.

Qualifications: MBBS, DCH, MD (Paediatrics), MRCPCH (UK).

Current memberships: British Paediatric Neurology Association, International League against Epilepsy and Royal College of Paediatrics and Child Health.

Special Interests: Complex epilepsy, epilepsy surgery, clinical neurophysiology and invasive epilepsy surgery monitoring.


Sasha Burn
Copy of Sasha Burn 4- webSasha works in Paediatric Neurosurgery at Alder Hey and Fetal Medicine Unit at Liverpool Women’s Hospital.

Her clinical interests include Epilepsy Surgery, Craniofacial Surgery, Fetal Central Nervous System Anomalies and Antenatal Counselling and General Paediatric Neurosurgery.

Sasha trained in Paediatric Neurosurgery in Leeds and at Great Ormond Street, followed by a 15 month fellowship at the Hospital for Sick Children in Toronto, Canada. Sasha has a long standing interest in functional Neurosurgery including Epilepsy Surgery and Fetal CNS Anomalies. She also works within Alder Hey’s Craniofacial Surgery team.

Qualifications: MB ChB, FRCS (SN)

Current Memberships: Royal College of Surgeons, Society of British Neurological Surgeons, British Paediatric Neurosurgery Group, American Association of Neurological Surgeons, Children’s Cancer and Leukaemia Group, Medical Protection Society, British Medical Association,

Department and Specialities: Paediatric Neurosurgery in Alder Hey and Fetal Medicine Unit at Liverpool Women’s Hospital. Epilepsy surgery, Craniofacial surgery, Fetal Central Nervous System anomalies and Antenatal Counseling, General Paediatric neurosurgery.

Mr Vivek Josan

Vivek JosanAfter completing his neurosurgical training in Birmingham U.K., Vivek went to Melbourne, Australia for a fellowship in Paediatric and Epilepsy Neurosurgery. Since returning to the U.K., he has been working in Royal Manchester Children’s and Salford Royal Hospitals NHS trust as a Consultant Neurosurgeon since 2007. He has set up a comprehensive and successful Paediatric Epilepsy Surgery programme at RMCH and an Adult Epilepsy Surgery Programme at Hope Hospital.

In addition to his clinical commitments, Vivek is actively involved in teaching and research to neurosurgical trainee sand fellow healthcare professionals. He has several publications in peer reviewed journal and has presented extensively at national and international neurosurgical and epilepsy meetings.

Vivek is a member of the Society of British Neurosurgeons, British Paediatric Neurosurgery Group, Congress of Neurological Surgeons – USA and of the ILAE.


Sarah Doyle

Sarah Doyle 3Sarah qualified as a Clinical Physiologist (Neuro) in 1984. During my training I worked at Great Ormond Street Hospital for 6 months.

She worked at The National Hospital, Queen Square, London from 1984 to 1989. I moved to work at St Georges Healthcare Trust, London as the clinical manager of the Neurophysiology department where she set up the video EEG telemetry service for adults and children.

As a result of her involvement in video EEG telemetry she developed an interest in Epilepsy, attending the MSc in Epileptology from 1997 to 1999 at Kings College Hospital.

Sarah’s family relocated to the North West in 2001. Sarah initially worked at Hope Hospital and for the past seven years has worked at Central Manchester University Hospitals. Since the relocation of Royal Manchester Childrens Hospital to the Central site in 2009 she have had a gradually increasing role in the Children’s Neurophysiology Department and is excited to be able to rekindle her interest in epilepsy with the department’s involvement in the epilepsy surgery programme.

Teresa Preston
Copy of Teresa PrestonTeresa Preston is the Neurophysiology department manager and Highly Specialised Clinical Physiologist at Alder Hey Children’s Hospital.

She gained qualification in 1985 and has nearly 30 years’ experience working as a clinical physiologist in Neurophysiology with a wide range of patients, both paediatric and adult.

Beginning her career at the Royal Liverpool University Hospital, she has also worked at the Countess of Chester Hospital but has gained most of her clinical experience working at the Walton Centre for Neurology and Neurosurgery, Liverpool.

She manages a team of Clinical Physiologists at Alder Hey where she is responsible for managing the department along with performing a wide range of Neurophysiology techniques including invasive video-telemetry monitoring and mapping procedures, which are an integral part of the epilepsy surgery programme.

She has travelled extensively over the years and worked for a short time in Sarawak, Borneo were she was involved in a research project, looking at the long term neurological effects of Japanese encephalitis in children in Asia.

Tamarin Foy
Tamarin Foy is a Highly Specialised Clinical Physiologist at Alder Hey Children’s Hospital.

She gained qualification in 2000 and has over 13 years’ experience working as a clinical physiologist in Neurophysiology with a wide range of patients, both paediatric and adult.

Beginning her career at The Walton Centre, she has also worked at the Royal Liverpool Univeristy Hospital, Warrington Hospital and the Countess of Chester Hospital before joining the team at Alder Hey five years ago.

She is the lead physiologist for the Sleep Service at Alder Hey and also concurrently works within the Neurophysiology team performing a wide range of Neurophysiology techniques including invasive video-telemetry monitoring and mapping procedures, which are an integral part of the epilepsy surgery programme.


Copy of Stuart Rust 3Dr Stewart Rust
Dr Stewart Rust is a Consultant Clinical Psychologist in Paediatric Neuropsychology. Dr Rust completed his clinical training Doctorate at Manchester University in 2001 and a further post graduate diploma in Paediatric Neuropsychology in 2007. He has worked with children and young people with complex epilepsy for ten years, and he has worked within the trust with the Child and Adolescent Mental Health Directorate since 2001.

Dr Rebecca Bromley

Dr Bromley completed her BSc (hons) in Psychology at the University of Liverpool where she later studied for, and was awarded, her PhD in Neuroscience in 2009. Following the completion of her PhD she secured a place on the Doctorate in Clinical Psychology at the University of Manchester, graduating in 2012.

She briefly returned to the University of Liverpool where she worked as part of the Liverpool Epilepsy Research Group, leaving to take up a position here at Royal Manchester Children’s Hospital in May 2013. Continuing with the interests she developed during her PhD Dr Bromley has chosen to specialise in Paediatric Neuropsychology working as part of the Paediatric Neuropsychology Team at Royal Manchester Children’s Hospital under the lead of Dr Stewart Rust, Consultant Clinical Psychologist.

Dr Bromley currently works part time at the hospital in the complex epilepsy team and part time at the University of Manchester on an NIHR Research Fellowship conducting research into child health and development following exposure to medications during pregnancy.


Dr Lakshmi Ramasubramanian
Consultant Child and Adolescent Psychiatrist & Honorary Lecturer, School of Mental and Behavioural Health Sciences, University of Liverpool

Lakshmi is a Consultant Child Psychiatrist and Paediatric Neuropsychiatrist at Alder Hey Children’s NHS Foundation Trust. She graduated from Madurai Medical College in 1998 and completed higher specialist training in Child and Adolescent Psychiatry in Merseyside before taking up the current post in 2011.

Lakshmi has a particular interest in mental health of children with Learning Disabilities and Epilepsy.

Apart form this, she is actively involved in Teaching and Training and is the Training programme Director for Child and Adolescent Psychiatry at Health Education North West (Mersey). She is also an Honorary Lecturer with School of Mental and Behavioural Health Sciences, University of Liverpool.

Qualifications: MBBS, MRCPsych, PGCert in Teaching and Learning in Clinical Practice

Current Memberships: Fellow, Higher Education Academy, Royal College of Psychiatrists, Child and Adolescent Learning Disability Psychiatrists Network, Hospital Consultants and Specialists Association
Department and Specialties: Child and Adolescent Psychiatry, Mental Health of Children with Severe Learning Disabilities

Clinical and Research Interests: Neuropsychiatry, Severe Learning Disabilitiesm Childhood Obesity

Hilary Lloyd
Hilary Lloyd is a Consultant Child & Adolescent Psychiatrist, at Royal Manchester Children’s Hospital and Salford Child & Adolescent Mental Health Service (CAMHS). She graduated from Manchester University in 1978. She completed her basic training in psychiatry in Manchester and then gained some experience in paediatric neurology.

After higher training in child and adolescent psychiatry in Manchester, Salford, and the Child Epidemiology Unit, McMaster University, Ontario, becams a consultant child & adolescent psychiatrist in 1988, initially in South Manchester, moving to her current post in 1990. Her particular clinical interests are in learning disability, autism and neuropsychiatry. She has been Clinical Director of the CAMHS Directorate, Central Manchester University Hospitals, since 2001


Shivvam Avula 2 - CopyShivaram Avula

Shivaram is a Consultant Paediatric Radiologist at Alder Hey with an interest in Neuroimaging. He completed Paediatric Radiology fellowships at Alder Hey and the Hospital for Sick Children in Toronto, Canada.

His clinical interests include head & neck imaging, neuroimaging for brain tumours, epilepsy and other childhood neurological disorders. Research interests includes advanced neuro MRI techniques for brain tumours and intraoperative MRI .

Current memberships: Royal College of Radiologists, British Society of Paediatric Radiology , British Society of Neuroradiologists, UK Childhood Cancer and Leukaemia Group, European Society of Pediatric Oncology – Brain Tumour group.

Stavros Stivaros 1 - CopyStavros Stivaros



Copy of P1070474Andrea McLaren – Lead Nurse

Andrea was appointed in November 2013 as Lead Nurse for the Children’s Epilepsy Surgery Service working across Alder Hey and the Royal Manchester Children’s Hospitals (RMCH). Her role provides professional leadership in epilepsy nursing and epilepsy surgical practice across the network and includes managing the children’s epilepsy surgery specialist practitioners at Alder Hey and RMCH.

Andrea had previously worked for fifteen years as a children’s epilepsy nurse in Manchester where she was founder member of the Paediatric Epilepsy Group (PEG) a clinical support group for nurses working in the field of children’s epilepsy. She has also been a long standing member of the North West Epilepsy Special Interest Group (NWEIG).

She qualified as an independent non- medical prescriber over eight years ago and is currently finishing her MSc in Advancing Nursing Practice.

Her particular interest within the field of epilepsy is around supporting and empowering children, young people and their families during their epilepsy journey.

Outside interests in addition to running around after three children and being a golf widow……. include theatre, reading, the Yorkshire Dales and trying to support Liverpool Football Club whilst living in a house full of Mancunians supporting those other reds!

Ben Cooper – Specialist Nurse Practitioner


Ben has worked in Paediatric Neurosurgery for the last 15 years. Beginning his career at the Walton Centre for Neurology & Neurosurgery he has since worked at the Royal Children’s Hospital in Melbourne.

He joined the team at Alder Hey 8 years ago working as a Senior Charge Nurse within the supra-regional Neurosurgery Department. He has a special interest in post-operative wound management and in addition currently leads the Vagus Nerve Stimulation (VNS) service for children with complex epilepsy. Following a 10 month secondment with the Epilepsy Nurse Specialist team he took up this most recent post within the Northern Children’s Epilepsy Surgery Service (NorCESS).

Emily Tolno – Epilepsy Surgery Network Coordinator

Emily has worked in medical administration for over 9 years. She studied a Masters at St Andrews University graduating in 2000 and since then has worked in various administration roles both in the UK and overseas setting up new services within a multidisciplinary team setting.

Her latest role was as a Medical Secretary within the Paediatric Neurology Department at RMCH allowing her to gain a wide knowledge of working with the specialist epilepsy teams both within RMCH and across the North West Tertiary Clinics. Previous to this she worked in the Christie Hospital as a PA to the Director of Haematology and BMT and also with the local PCT and Job Centre plus setting up a Condition Management Programme.

Emily has spent a few years overseas working with the International NGO Mercy Ships establishing and managing a Play Therapy Rehabilitation Programme in Sierra Leone, West Africa – not only administratively but also in training the national staff in programme development.

When not at work Emily enjoys being a first time mum and spending time with her young daughter.

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