Neurologist: What They Do and When to See One (original) (raw)
Overview
A neurologist treats disorders that impact the brain, spinal cord, and nerves.
Neurologists specialize in and treat disorders that impact the brain, spinal cord, and nerves.
Neurologists diagnose and treat problems of the nervous system that include:
- Alzheimer's disease
- Parkinson's disease
- Multiple sclerosis
- Stroke
- Amyotrophic lateral sclerosis (ALS)
- Epilepsy
- Migraine
- Concussion
See what to expect at your appointment and when you need to consult a neurologist.
What Does a Neurologist Do?
Neurologists diagnose and treat nervous system disorders. Your nervous system includes the central nervous system consisting of your brain and spinal cord, and the peripheral nervous system which comprises the nerves in the rest of your body.
Some of the other conditions neurologists treat include:
- Brain and spinal cord injuries
- Headaches
- Pain
- Multiple sclerosis
- Tremors
- Speech and language disorders
- Infections of the brain and peripheral nervous system
- Seizures
- Muscle weakness
Although both types of neurologists and neurosurgeons are neurology specialists, neurologists don't do surgery. That's what neurosurgeons do. These two types of doctors often work together, particularly when treating patients with complex neurological conditions. You might use a neurologist as your main doctor if you have a neurological condition. Or, your neurologist might diagnose your problem and then work with your regular doctor. If the neurologist deems surgery may be required, they will refer you to a neurosurgeon, but after the surgery, one usually continues long-term care back with the neurologist.
Neuroscientists are different from neurologists. A neuroscientist does not have a clinical practice, but studies and conducts scientific research on the development, physiology, and function of the nervous system, and how to apply this knowledge to the treatment of nervous system disorders. The difference between a neurologist and a neuroscientist is, that a neurologist clinically diagnoses and treats patients, and must be a medical doctor. Neuroscientists may or may not have a degree in medicine, but usually have a doctorate in neuroscience.
How to Become a Neurologist
In the United States, neurologists attend 4 years of college, 4 years of medical school, 1 year of internship, and then at least 3 years of training in a neurology residency program.
Neurologists can also have extra training in the following:
- Epilepsy
- Movement disorders
- Neuromuscular disease
- Stroke
- Sleep medicine
- Neuro-intensive care
- Neurodevelopmental disorders
- Neuro-oncology
- Geriatric neurology
- Vascular neurology
Pediatric neurologists treat children from birth to adolescence. They address many of the same conditions that adults have. They also have the training to manage developmental problems and genetic conditions.
When to See a Neurologist
If you're worried about symptoms that might be neurological, talk to your regular doctor. Your doctor might help you manage the problem or suggest you see a neurologist.
Many symptoms could prompt a referral to a neurologist, including:
- Severe headaches
- Dizziness
- Prolonged numbness or tingling or numbness on one side of the body
- Chronic pain, including pain with weakness or numbness
- Seizures
- Intense muscle weakness
- Problems walking
- Tremors that affect daily activities
- Certain vision problems
- Changes in your personality
- Trouble speaking
- Memory problems
- Sleep problems
Some neurologic problems, when they arise suddenly, can be signs of stroke. Some of the signs you should be aware of and get help for include:
- Tingling or numbness
- Weakness in your arm, hand, or leg
- Numbness on one side of your body
- Sudden trouble speaking
- Abrupt loss of vision
- Dizziness
- Confusioni> If you think you may be having a stroke, call 911 immediately.
What to Expect at Your Appointment
Your neurologist will ask all about your health history. You will also have a physical exam to test your coordination, reflexes, sight, strength, mental state, and sensation.
The neurologist may order other tests such as:
- Blood and urine tests: To identify the presence of any infection, toxins, or disorders of proteins or other essential elements in the body.
- MRI: This test uses magnetic fields and radio waves to take pictures of your inner brain. You'll lie down inside a machine for about 30-45 minutes.
- Computerized Tomography (CT) or Computer-Assisted Tomography (CAT) scans: X-rays and computers create multi-dimensional images of your body. A healthcare provider might inject dye to make arteries, blood vessels, tumors, or other areas visible in the image.
- Electroencephalogram (EEG): Electrodes attached to your scalp record your brain's electrical activity.
- Transcranial Doppler (TCD): An ultrasound probe placed on your head measures blood flow in your brain by using sound waves.
- Spinal Tap or Lumbar Puncture: A doctor numbs your back and removes spinal fluid with a needle. Doctors can then check for bleeding, infection, and other disorders.
- Electromyogram (EMG): This test tracks electrical activity in your muscles and nerves to help find the cause of pain, numbness, and weakness. The doctor inserts small needles into your muscles to test activity. The doctor delivers mild shocks on the surface of your body to record nerve activity.
The neurological diagnostic tests are conducted by a neurologist technician, who is not a medical doctor but is trained specially to maintain and operate neurological diagnostic equipment, and summarize the test data so that neurologists can interpret the information and make a diagnosis.
What Can a Neurologist Diagnose From All These Tests?
The neurologist may be able to find the cause of your neurological symptoms and prescribe the appropriate treatment. In addition to a physical exam and tests, you could receive a lot of information at your appointment with the neurologist on ways to manage your symptoms. It can be helpful to bring a family member or friend with you. The person you bring can help listen, ask questions, and take notes.
The tests may not always be able to pinpoint the source of your neurological symptoms. Some people may have “functional neurological symptoms” such as pain, fatigue, limb weakness, numbness, tremors, movement disorders, or blackouts, but nothing abnormal may turn up in the tests. Functional neurological symptoms refer to symptoms that are not explained by the presence of any disease or nerve damage.
What Do Neurologists Really Think of Functional Symptoms?
Up to one-third of neurology outpatients may have symptoms not explained by a definite neurological disease. An experienced neurologist usually performs further clinical examinations to assess functional symptoms and explains the diagnosis carefully to the patient.
To treat functional symptoms, the neurologist may suggest therapies that can include:
- Physiotherapy
- Distraction techniques
- Graded exercises
- Cognitive behavioral therapy
- Occupational therapy
Neurologists may be uncertain about the right approach toward patients with functional symptoms because it is sometimes very difficult to make a correct diagnosis in such cases. However, functional symptoms can persist and can be distressful and disabling for the patient necessitating referral to physicians with other medical specialties.
Frequently Asked Questions (FAQs) About Neurologists
What does a neurologist treat you for?
A neurologist treats you for all types of illnesses associated with the nervous system. Nervous disorders can affect your physical functions such as movement and balance, your sleep, or your cognitive functions such as memory, thinking, and decision-making abilities.
The nervous system consists of your brain and spinal cord, and a complex network of nerves that run through the entire body, regulating the function of every organ in your body. The nervous system enables muscle movement, speech, special senses such as sight, hearing, smell, taste, and touch, secretion of the natural fluids in your body, and other functions such as breathing, heartbeat, blood vessel contraction and dilation, intestinal functions, and bladder and bowel control.
Some of the conditions that a neurologist may treat you for include:
- Headaches such as migraines, cluster headaches, or tension headaches
- Chronic nerve pain disorders such as trigeminal neuralgia or postherpetic neuralgia
- Nerve diseases caused by other diseases such as diabetic neuropathy, or encephalopathy associated with liver diseases
- Stroke is caused by either bleeding or impaired blood flow due to a blood clot in the brain
- Neurological disorders such as multiple sclerosis, epilepsy, seizure disorders, Parkinson's disease, Alzheimer's disease, and other forms of dementia
- Neuromuscular disorders such as myasthenia gravis, peripheral neuropathy, and muscular dystrophy
- Spinal injuries, traumatic brain injury, or concussions
- Movement disorders such as tremors, restless leg syndrome, and those caused by long-term use of certain medications
- Neurodevelopmental disorders such as autism spectrum disorder or attention deficit and hyperactivity disorder (ADHD)
Why would you need to see a neurologist?
You would need to see a neurologist if you develop symptoms suggestive of a neurological condition. Some symptoms may have other underlying causes. See your primary care physician first and discuss your symptoms with them and they will be able to determine if you need to see a neurologist and refer you to one.
You may need to see a neurologist if you experience any of the following:
- Severe, persistent, or chronic headaches
- Vertigo and dizziness
- Ringing in the ears or loss of hearing
- Vision problems
- Changes in taste or smell
- Speech difficulty or language problems
- Seizures or loss of consciousness
- Progressive memory loss
- Unexplained muscle weakness
- Tremors and tics
- Difficulty with movement or loss of balance
- Numbness, tingling, and burning or shock-like pain
What will a neurologist do on your first visit?
On your first visit, the neurologist will go through your medical history, check you clinically, and prescribe blood, urine, and neurodiagnostic tests to determine the cause of your symptoms. Based on the test results, the neurologist will prescribe medications, physical and/or occupational therapy, or refer you to a neurosurgeon if you need surgery.
Carry your medical records with you if you have undergone any previous tests or treatments that are relevant to your condition. Noting down information on your symptoms and concerns before arriving at your appointment with the neurologist can help make sure you don't miss out on conveying any information or asking any questions that you have.
What is the job of a neurologist?
A neurologist performs the necessary clinical checkup, blood, urine, and neurological tests to diagnose neurological disorders and provide appropriate treatment. A neurologist will work in coordination with the primary care physician or a neurosurgeon, particularly when treating patients with complex neurological issues that require treatment from multiple specialists. People with chronic neurological conditions may need to receive regular care from a neurologist.
What is treated by a neurologist?
Neurologists treat all conditions that affect the nervous system including:
- Neuralgias
- Different types of chronic headaches
- Epilepsy
- Tremors
- Parkinson's disease
- Alzheimer's disease
- Disorders that affect the special senses including vision, hearing, smell, taste, and touch
- Developmental disorders such as autism
- Disorders of cognitive functions
What are the two types of neurologists?
The two types of neurologists include:
- Neurology physicians: Neurologists who are trained to diagnose and treat neurological conditions with medications, and physical and behavioral therapies.
- Neurosurgeons: Neurologists who are trained to diagnose neurological conditions and to perform neurosurgeries.
Why would I be seeing a neurologist?
You would be seeing a neurologist if you have nerve-related symptoms such as numbness, tingling, and burning pain, chronic headaches, seizures or blackouts, vertigo, muscle weakness, problems with the senses of touch, sight, hearing, taste and smell, memory loss, speech or language difficulties, or sleep issues. See your primary physician first, who will be able to direct you toward the right specialist and treatment, because many diseases have a lot of symptoms in common.
Seek emergency medical care if you have, or someone around you has stroke symptoms. Use the F.A.S.T test:
- Face: Check if one side of the face droops or if the smile is lop-sided
- Arm: Check if one arm drifts down or fails to lift when both arms are lifted
- Speech: Check if speech is slurred
- Time: Don't waste time if any of the above are present. Act FAST and call 911.
References
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American Academy of Neurology: “What Is a Neurologist?”
University of Rochester Highland Hospital Neurology: “What Is a Neurologist?”
Merck Manuals: “Overview of the Peripheral Nervous System.”
Brain & Life/American Academy of Neurology: “Working With Your Neurologist.”
University of Utah Health: “Should You See a Neurologist?”
Harvard Health Publishing: “Know the Signs of Stroke.”
Brain & Life/American Academy of Neurology: “Preparing For an Office Visit.”
National Library of Medicine. PubMed Central. “Functional neurological symptoms.” Dated: February 2013. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5873716/