What is a neurologist?
A neurologist is a medical doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system. A neurologist’s educational background and medical training includes an undergraduate degree, four years of medical school, a one-year internship and three years of specialized training. Many neurologists also have additional training in one area of neurology such as stroke, epilepsy or movement disorders.
What is the role of a neurologist?
Neurologists are principal care providers or consultants to other physicians. When a patient has a neurological disorder that requires frequent care, a neurologist is often the principal care provider. Patients with disorders such as Parkinson’s disease, Alzheimer’s disease or multiple sclerosis may use a neurologist as their principal care physician. In a consulting role, a neurologist will diagnosis and treat a neurological disorder and then advise the primary care physician managing the patient’s overall health. For example, a neurologist would act in a consulting role for conditions such as stroke, concussion or headache.
Neurologists can recommend surgical treatment, but do not perform surgery. When treatment includes surgery, neurologists will monitor surgically treated patients and supervise their continuing treatment. Neurosurgeons are medical doctors who specialize in performing surgical treatments of the brain or nervous system.
How are neurological disorders treated?
Many disorders can be treated. Treatment or symptomatic relief is different for each condition. To find treatment options, neurologists will perform and interpret tests of the brain or nervous system. Treatment can help patients with neurological disorders maintain the best possible quality of life.
What is a neurological examination?
During a neurological examination, the neurologist reviews the patient’s health history with special attention to the current condition. The patient then takes a neurological exam. Typically the exam tests vision, strength, coordination, reflexes and sensation. This information helps the neurologist determine if the problem is in the nervous system. Further tests may be needed to confirm a diagnosis or to find a specific treatment.
Some common neurologic tests are:
- Computerized tomography or computer-assisted tomography (CT or CAT scan)*
- Magnetic resonance imaging (MRI) *
- Electroencephalogram (EEG)
- Electromyogram including nerve conduction study (EMG)
- Evoked potentials
- Sleep studies
- Cerebral spinal fluid analysis (Spinal Tap or Lumbar Puncture)
* Performed offsite
This test uses x-rays and computers to create multi-dimensional images of selected body parts. Dye may be injected into a patient’s vein to obtain a clearer view. Other than needle insertion for the dye, this test is painless.
Magnetic Resonance Imaging (MRI).
An MRI is an advanced way of taking pictures of the inner brain. It is harmless and involves magnetic fields and radio waves. It is performed when a patient is lying in a small chamber for about 30 minutes. It is painless, but may be stressful for individuals with claustrophobia (fear of closed areas). A physician can offer options to help you relax.
The EEG records the brain’s continuous electrical activity through electrodes attached to the scalp. It is used to help diagnose structural diseases of the brain and episodes such as seizures, fainting, or blacking out. This test is painless.
An EMG measures and records electrical activity in the muscles and nerves. This may be helpful in determining the cause of pain, numbness, tingling, or weakness in the muscles or nerves. Small needles are inserted into the muscle and mild electrical shocks are given to stimulate the nerve (nerve conduction study). Discomfort may be associated with this test.
This test records the brain’s electrical response to visual, auditory, and sensory stimulation. This test is useful in evaluating and diagnosing symptoms if dizziness, numbness, and tingling, as well as visual disorders. Discomfort may be associated with this test.
These tests are used to diagnose specific causes of sleep problems. To perform the tests, it is often necessary for a patient to spend the night in a sleep laboratory. Brain wave activity, heart rate, electrical activity of the heart, breathing, and oxygen in the blood are all measured during the sleep test. These tests are painless.
Cerebrospinal Fluid Analysis (Spinal Tap or Lumbar Puncture).
This test is used to check for bleeding, hemorrhage, infection, or other disorder of the brain, spinal cord, and nerves. In this test, the lower back is numbed with local anesthesia and a thin needle is placed into the space that contains the spinal fluid. The amount of spinal fluid that is needed for the tests is removed and the needle is withdrawn. Discomfort may be associated with this test.
Why do patients need a neurological examination?
An examination is used when a family doctor seeks a specialized opinion about a patient whose symptoms may involve the brain or nervous system. The examination may also be performed when a patient wants a second opinion from a neurologist. The neurologist’s expertise in disorders of the brain and nervous system can give patients effective diagnosis and treatment for neurological disorders.
(Information provided by the American Academy of Neurology)