BC Centre for Complex Nerve Injury

Established in 2011, The B.C. Centre for Complex Nerve Injury provides a unique full service multidisciplinary management approach to peripheral nerve injury and trauma. Our full service value-based health-care model provides patients the opportunity to see a team of expert physicians and receive care from peripheral nerve surgeons, neurologists, physiatrists, and electrodiagnostic technicians in a single visit. As a team, patient care and management plans are created - patients are then followed throughout the whole course of their treatment.

For Referrals to the BC Centre for Complex Nerve Injury please fax referral to Complex Nerve Injury Clinic at: 604-875-5861

Our Team

Plastic Surgery
Dr. Sean Bristol (Co-Director)
Dr. Bristol is the co-founder and surgical lead of the BC Centre for Complex Nerve Injury. From a two-physician program based off the successful model developed in London, Ontario, Bristol has expanded the team to include nine physicians under three different sub-specialty areas. Outside of work, I enjoy a busy family life and travel and personally enjoy golf, tennis and reading.
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Dr. Chris Doherty
Dr. Christopher Doherty completed his undergraduate degree in the Integrated Science program (microbiology and physiology) at the University of British Columbia, before attending the University of Calgary to receive his medical degree. While at the University of Calgary as a plastic surgery resident, he also completed the Surgeon Scientist Program, and headed to Boston, Massachusetts where he earned a Master of Public Health from Harvard University. Following his graduate studies and residency training in 2013, Dr. Doherty completed the Roth | McFarlane Hand and Upper Limb Centre fellowship in Hand and Upper Extremity Surgery, subsequently joining the Centre and the Department of Surgery at Western University as an Assistant Professor in 2014. In 2019, Dr. Doherty joined the University of British Columbia Division of Plastic Surgery where he continues his clinical and research interests as a Clinical Associate Professor in peripheral nerve-brachial plexus surgery, hand and upper extremity reconstruction. He is a member of the BC Centre for Complex Nerve Injury Clinic, GF Strong Complex Upper Extremity Clinic and iCORD in Vancouver.
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Dr. Alex Seal
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Dr. David Tang
Dr. David Tang completed his undergraduate studies in science and education, earning degrees at UBC and UVIC respectively. After teaching high school science for a couple of years he entered and completed medical school at UBC before moving to the east coast to pursue his Plastic Surgery residency training at Dalhousie. Following his residency, he completed the hand and peripheral nerve fellowship at Washington University in St. Louis under Dr. Susan Mackinnon. He then returned to Halifax for the first 10 years of his practice, engaging in upper extremity surgery and medical education. He earned his Masters degree in education and has been able to marry his careers as a residency training Program Director, national leader in medical education and clinical Associate Professor in upper extremity surgery. Dr. Tang joined the UBC Division of Plastic Surgery in 2021 and is excited to be part of a world class multidisciplinary team.
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Neurology
Dr. Kristine Chapman (Co-Director)

MD, FRCPC, SCNS (EMG)
Clinical Professor, UBC Medicine
Physician Lead for Innovation and Quality, PHC Dept of Medicine
Head of Neurology, Providence Health Care

Dr. Chapman is a Clinical Professor of neurology at the University of British Columbia. She completed her undergraduate degree in Occupational Therapy, and Neurology training at UBC followed by a Neuromuscular and Neurophysiology Fellowship at Harvard. Her interests include autoimmune neuropathies and complex nerve injuries.
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Dr. Kristin Jack
Dr. Kristin Jack was born in Saskatoon, Saskatchewan. She received her 4-year Advanced Bachelor of Science with Great Distinction in Biology from the University of Saskatchewan in 2003. She obtained her Doctor of Medicine from the University of Saskatchewan in 2007, with clerkship training done both through the University of Saskatchewan and the University of Calgary. Her Post-Graduate Neurology training was completed through the University of British Columbia from 2007 to 2012. Furthermore, she fulfilled a 2-year Neuromuscular/EMG Fellowship at Western University, with sub-specialization in Myasthenia Gravis (MG). She obtained her EMG CSCN Diplomate, Canadian Society of Clinical Neurophysiologists EMG Examination and Certification, in June 2014.
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Dr. Shahin Khayambashi
Dr. Shahin Khayambashi grew up in North Vancouver and completed his BSc and MD at the University of British Columbia. He then completed a 5-year Adult Neurology residency at the University of Manitoba in Winnipeg. This was followed by a 1-year Clinical Neuromuscular fellowship at the University of Calgary with an added focus on nerve and muscle ultrasound. His research interests include sonographic characterizations of various peripheral nerve disorders and during fellowship he was awarded a research grant through Hereditary Amyloidosis Canada. Dr. Khayambashi is also passionate about medical education with particular focus on Neuromuscular and Ultrasound education.
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Physical Medicine & Rehabilitation
Dr. Mike Berger
Dr. Mike Berger completed the combined MD/PhD program at Western University; PhD in the Integrated Physiology of Exercise (2011) and undergraduate medical training (2013). He then went on to complete residency training in Physical Medicine & Rehabilitation at the University of British Columbia. In his final year of training, he completed sub-speciality training in electrodiagnostic and neuromuscular medicine at Vancouver General Hospital. Dr. Berger is a Fellow of the Royal College of Physicians and Surgeons of Canada in Physical Medicine & Rehabilitation and is a Diplomate of the Canadian Society for Clinical Neurophysiology (certified in EMG).
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Dr. Cameron Cunningham
Dr. Cameron Cunningham is a Physical Medicine and Rehabilitation (PMR) specialist and Clinical Instructor in the Department of Medicine at the University of British Columbia. He received his BSc from Simon Fraser University, his MSc from University of Calgary and his MD and specialty training from University of British Columbia. He is a Fellow of the Royal College of Physicians and Surgeons of Canada (FRCPC) and is certified in electromyography (EMG) through Canadian Society of Clinical Neurophysiologists (CSCN).
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Dr. Russell O'Connor
Dr. O’Connor graduated from the University of Calgary medical school in 1998 and completed his Physical Medicine and Rehabilitation Fellowship at the University of British Columbia in 2003. He is one of the founding physicians of GF Strong’s spasticity clinic and is medical manager of the GF Strong neuromuscular program and medical director of the EMG lab. He is one of the Physiatrist at the BC Centre for peripheral nerve injury and GF Strong’s SCI Upper limb functional restoration clinic (ULFRC).
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Medical Office Assistant
Jimmy L.
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Conditions

Axillary Neuropathy
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Fibular Neuropathy
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Lower Trunk Plexopathy and C8/T1 Nerve Root Avulsion
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Lumbosacral Plexopathy
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Neuroma and Phantom Limb Pain
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Radial Neuropathy
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Sciatic Neuropathy
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Upper Trunk Plexopathy and C5/6 Nerve Root Avulsion
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Advances in nerve repair

Cervical Spondolytic Amyotrophy
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Tendon Transfer
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Common Nerve Transfers
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Nerve Transfer
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Nerve Grafting
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Direct Nerve Repair
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Patient Journey


1. Initial Assessment

Initial Assessment
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Nerve injury Team
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Next Steps
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2. Neuropathic pain

Managing Neuropathic Pain
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Commonly Used Medications
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3. Surgery

Preparing for Surgery
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Day of Surgery
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4. Rehabilitation

Pre-operative planning for rehab
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Phase 1: Protective (0 - 3 weeks postop)
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Phase 2: Corrective (3 weeks to 5-8 months postop)
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Phase 3: Motor Retraining (5 - 12 months postop)
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Phase 4: Strengthening and functional movements (12 - 24 months postop)
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General Information
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Referrals

When should patients be referred?

As soon as possible after their injury.  Patients referred to the Complex Nerve Injury Program will be expedited. We typically will wait for 2 weeks post injury, to allow for Wallerian degeneration of nerve, which enables better prognostication and localization, We would ideally like to assess patients within 3 months of the injury, or sooneer.

Education/Research

Our team is very active in research, with the hope that our research projects will lead to better understanding of nerve damage, and improvements in treating nerve conditions. There are many opportunities to participate in research projects. These range from completing short questionnaires when you come to clinic, to making a special visit to our research laboratory so that we can gain a more detailed understanding of how your nerves and muscles are working. We use techniques such as ultrasound, electrical stimulation and special needle recordings of your muscles, to better understand nerve injuries. Our research laboratory is under the direction of physiatrist Dr. Mike Berger, and is located down the street from the BCCNI, at the Blusson Spinal Cord Centre.Research is voluntary, meaning that you are not obligated to participate in research. If you do participate, it will have no impact on the medical care you receive. You have the right to withdraw from research studies at any time and your medical care will not be affected. For some studies, we are able to offer a small honorarium (usually $50) to cover your transportation costs.

Examples of ongoing research projects:
1. Clinical evaluation of individuals with nerve injuries. In this study, we will be asking you to complete questionnaires about your nerve injury. Depending on the severity of your injury and whether or not you have surgery, this study can last as long as two years, with questionnaires being completed every 3-6 months
2. Measuring the effect of nerve transfer surgery. This study is a laboratory evaluation of how well your nerves “reconnect” with your muscles after surgery. In this study, we will be using electrical stimulation and small needle recordings to measuring how many nerves have reconnected with your muscles.
3. Measuring the effect of rehabilitation. In this study (in Dr. Berger’s laboratory), we are measuring how well your brain is able to “repurpose” the old donor nerve for the new recipient in action. In this study, we are using special machines to measure your muscle strength, both with and without electrical stimulation.

Recent publications
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Inquries
For peripheral nerve injury research Inqurires, please contact Dr. Berger's Lab Coordinator Dr. Harvey Wu.
Learn more about Dr. Berger

Our Partners