What is neurology?
Neurology is a specialty of medicine that studies and treats nervous system disorders. The nervous system is a sophisticated, complex mechanism that directs and controls physiological functions. It consists of two sections:
- The brain as well as the spinal cord (central nervous system)
- All other neural elements, such as eyes, hearing, skin, and other sensory receptors, are part of the peripheral nervous system.
Who is a neurologist?
A neurologist specializes in treating, diagnosing, and managing nervous system disorders. A neurologist can diagnose conditions by conducting various tests, including a physical examination and taking a patient's history. Tests can examine a patient's vision, speech, and mental status. They also test a person's coordination, strength, reflexes, sensation, and gait. A neurological examination is an integral part of a patient's evaluation. As symptoms of neurological disorders can be identical, it becomes imperative for physicians to conduct elaborate tests.
A crucial subspecialty of neurology is pediatric neurology, in which physicians train to diagnose and treat neurological issues in children. Many common adult illnesses, such as epilepsy, migraine, Tourette syndrome, and stroke, can be treated by child neurologists. Pediatric neurologists can also manage several developmental issues and neurogenetics issues.
A few conditions treated by neurologists include:
- Seizure disorders such as epilepsy
- Cerebrovascular diseases, such as stroke
- Neuromuscular illness
- Demyelinating diseases of the CNS, like multiple sclerosis
- Brain and peripheral nervous system infection
- Movement disorders, such as Parkinson's disease
- Brain abscesses
- Neurodegenerative disorders include Alzheimer's and Amyotrophic Lateral Sclerosis (Lou Gehrig's disease)
- Spinal cord disorders
- Speech and language disorders
What kind of tests do neurologists order for evaluations?
The following are a few tests that the neurologist may order for evaluation:
- Magnetic Resonance Imaging (MRI): This machine uses a magnetic field and radio waves, which are computer generated to create detailed images of the body's organs and tissues.
- EEG is an electroencephalogram (EEG): The EEG will record the electrical activity in your brain. This helps to track any abnormalities in the brain, such as tumors, inflammation, other traumas, and psychiatric illnesses.
- Electromyography (EMG): This test will look for electrical activity in your spinal cord or brain that leads to a peripheral nerve. EMG can help your doctor diagnose spinal cord diseases and muscle and nerve abnormalities. A neurologist will insert microscopic electrodes into the patient's muscles during this test. This allows the neurologist to track activity while the patient rests or moves.
- Tensilon test: The tensilon test is a method of determining illnesses such as myasthenia gravis. Tensilon is a drug that your neurologists will inject you with. Then, the doctor will examine your muscle movements depending on how the drug has affected you.
- Angiography: This imaging technique examines blood vessels in the brain, head, or neck to identify blockages, damage, aneurysms, or blood clots.
- Cerebrospinal fluid analysis: This involves extracting a little fluid near the brain and spinal cord to detect brain bleeds, infections, multiple sclerosis, and metabolic diseases.
- Biopsy: The removal of tissue, such as muscle, nerve, or brain tissue, for examination, aiding in diagnosing various conditions like cancer.
- Computed tomography (CT), X-rays, and ultrasound: These are imaging tests used for different purposes. While a CT scan detects injuries and diseases, an X-ray uses electromagnetic waves to study a particular organ. Further, ultrasound, which uses high-intensity sound waves, can show if there is any damage to the structures inside the body.
- Electronystagmography (ENG): This involves a group of tests to diagnose involuntary eye movement, dizziness, and balance disorders.
- Evoked potentials: This test measures the speed and completeness of electrical signals reaching the brain from eyes, ears, or skin, aiding in diagnosing conditions like multiple sclerosis and spinal cord injury.
- Positron Emission Tomography (PET): This is an imaging test that reveals tumors and assesses conditions such as epilepsy, brain tumors, dementia, and Alzheimer’s disease.
- Single-Photon Emission Computed Tomography (SPECT): This imaging test aids in diagnosing tumors and infections and assessing the location of seizures, degenerative spine disease, and stress fractures.
- Myelography: Used to diagnose spinal and spinal cord tumors, herniated disks, and fractures.
- Polysomnogram: Monitors brain and body activity during sleep, facilitating the diagnosis of sleep disorders.
- Thermography: Measures temperature changes within the body or specific organs, used to evaluate pain syndromes, peripheral nerve disorders, and nerve root compression.
Subspecialties in neurology
As the neurological system is so complex, neurologists specialize in particular sub-specialties. Neurologists who have completed their residency can pursue a fellowship in sub-specialties. These subspecialties assist doctors in focusing their attention on a specific area of neurology.
The following are some of the subspecialties:
- Vascular
- Interventional neuroradiology
- Epilepsy
- Neuromuscular medicine
- Headache medicine
- Neuro-oncology
- Geriatric neurology
- Autonomic diseases
How should one prepare for a visit to a neurologist?
It is time to prepare for the visit once you finalize the best neurologist near you. For your appointment, start by compiling a list of the most crucial issues you wish to discuss with the doctor. Communicating any changes in your overall health since your last appointment is essential. Detailing new symptoms or alterations in existing ones is vital. Consider maintaining a symptom diary, noting the day, time, duration, severity, triggers, and your response to each event, mainly if symptoms are intermittent.
Gather copies of relevant test results, including images and lab work, from healthcare providers outside the neurologist's network. Include all current medications, including prescriptions, supplements, over-the-counter drugs, vitamins, and herbal products. Make your neurologist aware of any past medications that were ineffective or caused adverse effects, and disclose your known allergies.
Consider bringing someone close to you to the consultation to assist with note-taking and serve as an additional set of ears and eyes. This support person can help review the neurologist's discussions, pose questions, and remind you of scheduled tests and follow-up appointments. Lastly, inquire about additional appointments to address any supplementary concerns. This thorough preparation ensures a more productive and comprehensive discussion with your neurologist.
What does the first visit to a neurologist include?
Various tests will be conducted during a neurological examination to assess muscle strength, memory, vision, eye health, and coordination. Although these tests are generally painless, they may cause slight discomfort. The following things are a part of the first visit:
- Inquiring about any medical conditions or medications, as well as current symptoms.
- Evaluating a person's posture, gait, coordination, and balance to identify any visible signs of a condition.
- Conducting a physical examination includes taking measurements of pulse and blood pressure and listening to the lungs and heart.
- Asking about bowel movements and urination can provide insight into the autonomic nervous system's functioning.
After this initial examination, a neurologist may then perform multiple assessments, these include:
- Tests of cranial nerves: These assess how well the nerves responsible for the senses are working. Examples include identifying smells and reading letters or numbers on an eye chart.
- Tests of coordination and motor skills: A neurologist may have the patient perform tasks like spinning, specific limb movements, finger tapping, or writing. The neurologist may also test reflexes by tapping the knee to check the response.
- Sensation tests: A neurologist may check a person's responses to stimuli such as touch or temperature.
- Tests of cognitive abilities: The doctor may assess the patient's memory by asking about their job, the date, or the time of year. Tests of language and math can evaluate concentration. Additional tests, such as the mini-mental state examination (MMSE) or the Montreal Cognitive Assessment (MoCA), may be used if a person shows symptoms of cognitive impairment. However, these tests are not always part of a standard evaluation.
Neurologist vs Neurosurgeon
Neurologists and neurosurgeons often work closely when managing and treating nervous system disorders. When you experience pain or have concerns about the brain, spinal cord, or nerves, you typically visit a neurologist near you for an initial evaluation. The neurologist is responsible for diagnosing the issue and determining whether surgical intervention is necessary. If surgery is required, the patient is referred to a neurosurgeon to perform the surgical treatment. However, many neurological conditions do not require surgery; the neurologist will manage the treatment plan in these cases.
Neurologists focus on continuously studying and researching the central nervous system (CNS)—the brain, spinal cord, and peripheral nerves. They specialize in diagnosing and treating neurological conditions such as migraines, epilepsy, multiple sclerosis, Parkinson's disease, and neuropathy. They often handle non-surgical treatments, including medications, therapies, and lifestyle recommendations. Neurologists are particularly skilled in managing chronic neurological conditions that may not necessarily threaten life but can significantly impact the patient's everyday life.
In contrast, neurosurgeons focus on surgical interventions for the nervous system. These professionals are trained to perform complex surgeries on the brain, spine, and peripheral nerves and manage conditions such as brain tumors, spinal cord injuries, aneurysms, and degenerative spinal diseases. Neurosurgeons undergo extensive training, including learning the nervous system's intricate details and developing surgical skills to execute precise operations. Their training period is one of the longest in the medical field, reflecting the complexity and delicacy of their procedures.
Becoming a neurosurgeon requires years of rigorous training beyond medical school, including residency programs lasting up to seven years or more. The high level of specialization ensures that neurosurgeons can handle intricate surgical procedures requiring utmost precision.
Finding the best neurologist near you in Philadelphia, PA
Neurological disorders can drastically impact the quality of life. Therefore, managing the conditions without leaving any stone unturned is essential. But finding a trusted neurologist can be challenging. This is where Zocdoc ensures you can reach out to the best healthcare providers.
Zocdoc helps you find the best neurologists in your vicinity with just a few simple steps. You can search for practitioners based on location, timing, and insurance carrier. Moreover, you can refine your search with our customized filters. You can also see detailed profiles of the practitioners on Zocdoc. This includes information about their education, experience, expertise, services offered, board certifications, awards, and even the languages they speak.
Zocdoc also helps you book appointments on weekends and even after 5 pm.
When scheduling an appointment on Zocdoc, you'll typically be asked to provide your insurance details or confirm that you'll be paying out-of-pocket. Some healthcare providers require insurance information upfront to secure the appointment. However, if you prefer not to share your insurance or plan to pay without using it, you can find another provider on Zocdoc that accommodates your preference. For more queries, you can visit the Zocdoc patient help center page.
Booking appointments with the best neurologists near you on Zocdoc is fast, secure, and free.
Neurology statistics in the US
In 2012, there were 16,366 active neurologists in the United States, with a projected increase of 18,060 by 2025. By 2025, demand for neurologists could rise from 18,180 in 2012 (an 11% gap) to 21,440 (a 19 percent shortfall).
In the year 2015, 1.2% of the population in the US had active epilepsy. This is around 3.4 million people, including 3 million adults and 470,000 adults.
In 2020, about 5.8 million people in the U.S. were living with Alzheimer's. The number of people living with the disease doubles every five years beyond 65. The number could triple to 14 million by the year 2060.
Sources
Medipulse
University of Rochester Medical Center
National Library of Medicine
Center for Disease Control & Prevention[1]
America's Health Rankings
Department of Health
Centers for Disease Control and Prevention[2]
Centers for Disease Control and Prevention[3]
Medical News Today
Cleveland Clinic
Brain and Spine Neuroscience Institute
