About Neurologist Speciality
A neurologist is a trained medical professional who
diagnoses and treats diseases of the nervous system in both men and women such
as coordination problems, muscle weakness, a change in sensation, confusion and
dizziness.
The medical field of neurology involves the study, research,
diagnosis, and management of health conditions that may affect the central and
peripheral nervous system including the brain and spinal cord.
A neurologist also caters to patients having problems
with their senses, such as touch, vision or smell.
In order to become a neurologist, one must complete graduation
from a medical college followed by an internship. After that, three years of
training in a Neurology residency program is necessary. A neurologist may
work in private practice or within a team setting at a neurology clinic or a
hospital.
Subspecialties of neurology
A neurologist may choose a specific field of neurology do a fellowship in that field after residency training. Subspecialties of neurology include:
- Neuromuscular Medicine
- Neurocritical Care
- Neuro-Oncology
- Geriatric Neurology
- Autonomic Disorders
- Vascular (Stroke Care)
- Child Neurology
- Intervention Neuroradiology
- Epilepsy
Diseases managed by neurologists
Stroke
A stroke occurs when a human brain does not receive adequate blood supply. A stroke is a medical emergency which needs swift treatment otherwise it could lead to death.
Symptoms of Stroke
Symptoms include difficulty speaking and understanding, numbness of the face, arm or leg, blurred vision, severe headache, difficulty swallowing or trouble walking.
Treatment of Stroke
A neurologist may prescribe aspirin to reduce the likelihood of having another stroke. An injection of a recombinant tissue plasminogen activator (TPA) is given to the patient to restore blood flow by dissolving the blood clot causing your stroke. To decrease your risk of having another stroke, a neurologist may suggest a carotid endarterectomy procedure followed by angioplasty and stent insertion.
Epilepsy
Epilepsy is a neurological disorder which occurs when cell activity in the brain becomes disrupted leading to seizures or periods of unusual behaviour, sensations and sometimes loss of consciousness.
Symptoms of Epilepsy
Symptoms include temporary confusion, staring blankly, uncontrollable jerking movements of the arms and legs, loss of consciousness or awareness and psychic symptoms.
Treatment of Epilepsy
A neurologist may prescribe anticonvulsant, anti-seizure drugs along with vagus nerve stimulator and ketogenic diet. He may suggest a brain surgery to treat the area of the brain that causes seizure activity.
Multiple Sclerosis (MS)
Multiple sclerosis is a neurological disorder which occurs when the immune system attacks the protective sheath that covers nerve fibres and causes communication problems between your brain and the rest of your body. It may disable the brain and spinal cord.
Symptoms of multiple sclerosis
Symptoms include numbness and tingling in one or more limbs, weakness, tremor, or clumsiness in the legs or hands, partial loss of vision, double vision, eye pain, or areas of visual alteration.
Treatment of multiple sclerosis
A neurologist may prescribe corticosteroids such as oral prednisone and intravenous methylprednisolone to reduce nerve inflammation along with plasmapheresis. For relapsing multiple sclerosis, he may suggest beta interferons, glatiramer acetate, dimethyl fumarate, fingolimod, teriflunomide, natalizumab or alemtuzumab.
Traumatic Brain Injury
A traumatic brain injury is described as a blow to the head or a penetrating head injury that disrupts the normal functionality of the brain. A serious brain injury can cause bruising, torn tissues, bleeding and other physical damage to the brain.
Symptoms of a traumatic brain injury
Symptoms include Loss of consciousness, feeling dizzy, headache, nausea or vomiting, drowsiness, difficulty sleeping, loss of balance, blurred vision, ringing in the ears, concentration problems, mood swings, feeling depressed or anxious.
Treatment of a traumatic brain injury
A neurologist may prescribe diuretics, anti-seizure drugs and coma-inducing drugs for the treatment of a traumatic brain injury. Emergency surgery may be needed to reduce additional damage to brain tissues including removing clotted blood, repairing skull fractures and opening a window in the skull.
Myasthenia Gravis
Myasthenia gravis is a neuromuscular disorder which occurs when there is a breakdown in the normal communication between nerves and muscles. This breakdown results in muscle weakness.
Symptoms of myasthenia gravis
Symptoms include trouble talking, problems walking or lifting objects, facial paralysis, difficulty breathing because of muscle weakness, swallowing problems, fatigue, hoarse voice, drooping of eyelids and double vision.
Treatment of myasthenia gravis
A neurologist may prescribe corticosteroids and immunosuppressants to suppress the immune system. Additionally, he may suggest Plasmapheresis (plasma exchange) to remove harmful antibodies from the blood, Intravenous immune globulin (IVIG) or removal of the thymus gland.
Dementia
Dementia is not actually a disease it is a group of thinking and social symptoms which affects memory and hinders day-to-day activities. Dementia is characterised by memory loss and misjudgement.
Symptoms of Dementia
Symptoms include memory loss, difficulty communicating, difficulty reasoning or problem-solving, difficulty handling complex tasks, difficulty with planning and organizing, difficulty with coordination and motor functions and confusion.
Treatment of Dementia
A neurologist may prescribe cholinesterase inhibitors such as donepezil, galantamine and rivastigmine to boost levels of a chemical messenger involved in memory and judgment along with memantine drug and other medications to treat other symptoms or conditions, such as depression, sleep disturbances or agitation.
Alzheimer's Disease
Alzheimer's disease is a progressive neurological disease that seriously damages memory and other important mental functions. In this disease, brain cells die on their own which gradually leads to memory loss and impaired mental functionally.
Symptoms of Alzheimer's disease
Symptoms include mental decline, difficulty thinking and understanding, confusion, delusion, forgetfulness, difficulty with self care, meaningless repetition of own words, anger, mood swings, hallucinations, loss of appetite or restlessness etc.
Treatment of Alzheimer's disease
A neurologist may prescribe cholinesterase inhibitors such as donepezil, galantamine and rivastigmine to boost levels of a chemical messenger involved in memory and judgment along with memantine drug. In order to help control the behavioural symptoms associated with Alzheimer's disease, a neurologist may suggest antidepressants.
Cerebral Palsy
Cerebral palsy is a disorder that affects muscle tone, movement and motor skills. It occurs due to damage to the immature, developing brain, most often before birth.
Symptoms of Cerebral palsy
Symptoms include stiff muscles, lack of muscle coordination, involuntary movements, difficulty walking, problems with swallowing, difficulty with sucking or eating, delays in speech development or difficulty speaking, difficulty with precise motions, such as picking up a crayon or spoon, seizures, favouring one side of the body, such as reaching with only one hand or dragging a leg while crawling etc.
Treatment of Cerebral palsy
A neurologist may prescribe onabotulinumtoxinA (Botox) injections to improve drooling along with oral muscle relaxants such as diazepam, dantrolene or baclofen.
Dystonia
Dystonia is a movement disorder in which your muscles contract involuntarily, causing repetitive or twisting movements. This medical condition can affect one or all parts of your body.
Symptoms of Dystonia
Symptoms include muscle contractions in your leg, neck or arm, involuntary spasms causing your eyes to close can make you functionally blind, slurred speech, drooling, and difficulty chewing, hoarse voice, etc.
Treatment of Dystonia
A neurologist may prescribe Botulinum toxin (Botox) to reduce muscle contractions and improve abnormal postures. Other medications may include levodopa, benztropine, tetrabenazine, trihexyphenidyl, diazepam, clonazepam and baclofen. A neurologist may also suggest surgical procedures such as deep brain stimulation and selective denervation surgery for the treatment of dystonia.
Parkinson's disease
Parkinson's disease is a central nervous system disorder that affects movement. It develops slowly with a noticeable tremor in just one hand. This disease may also lead to stiffness or slowing of movement.
Symptoms of Parkinson's disease
Symptoms include tremor, or shaking, usually begins in a limb, slowed movement making simple tasks difficult, muscle stiffness may occur in any part of your body, impaired posture and balance, speech changes, writing becomes difficult etc.
Treatment of Parkinson's disease
Medications a neurologist may prescribe include levodopa, dopamine agonists, MAO-B inhibitors like selegiline, rasagiline, catechol-O-methyltransferase (COMT) inhibitors like entacapone, anticholinergics like benztropine and amantadine. He may suggest deep brain stimulation (DBS) procedure to reduce Parkinson’s disease symptoms.
Migraine
A migraine can be described as a throbbing headache accompanied by nausea, vomiting, and extreme sensitivity to light and sound. The duration of pain may stretch to hours or days.
Symptoms of migraine
A migraine attack symptoms include seeing various shapes, bright spots or flashes of light, vision loss, needling sensations in an arm or leg, numbness in the face or one side of the body, difficulty speaking, uncontrollable jerking etc.
Treatment of migraine
A neurologist may prescribe pain-relieving drugs such as ibuprofen or acetaminophen to help relieve mild migraines along with triptan medications like sumatriptan, rizatriptan, almotriptan etc. He may also suggest Ergotamine and caffeine combination drugs, anti-nausea medications, opioid medications and glucocorticoids.
Ataxia
Ataxia refers to a group of diseases that impact co-ordination, balance and speech. Ataxia may also create difficulties with speech, eye movement and swallowing. It happens when a part of the brain that controls muscle coordination is damaged.
Symptoms of Ataxia
Symptoms include poor coordination, unsteady walk and a tendency to stumble, difficulty with eating, writing, slurred speech, back-and-forth eye movements, difficulty swallowing etc.
Treatment of Ataxia
The treatment for ataxia depends on exact what type of ataxia a patient has. A neurologist may suggest a number of measures to treat various symptoms of ataxia including speech and language therapy, occupational therapy, physiotherapy, injection of botulinum toxin for muscular problems, antimuscarinic for bladder problems, amitriptyline, gabapentin or pregabalin to ease nerve pain.
Huntington's disease
Huntington's disease is a hereditary and progressive brain disorder which causes breakdown of nerve cells in the brain. Huntington's disease can strike people of all ages. It can impact a person’s functional abilities.
Symptoms of Huntington's disease
Symptoms include muscle problems, such as rigidity or muscle contracture, involuntary jerking or writhing movements, difficulty with speech and eating, abnormal eye movements, fatigue and loss of energy, insomnia, suicidal thoughts, difficulty in learning new information, lack of flexibility etc.
Treatment of Huntington's disease
A neurologist may prescribe tetrabenazine, chlorpromazine, amantadine, levetiracetam for movement disorders and citalopram, fluoxetine, sertraline, quetiapine, olanzapine, anticonvulsants to treat psychiatric disorders.
Hydrocephalus
Hydrocephalus refers to an irregular accumulation of cerebrospinal fluid (CSF) within cavities in the brain called ventricles. This build-up increases the size of the ventricles and puts pressure on the brain.
Symptoms of Hydrocephalus
Symptoms include an unusually large head, rapid increase in the size of the head, tense soft spot on the top of the head, vomiting, sleepiness, irritability, seizures, eyes fixed downward, responsiveness to touch etc.
Treatment of Hydrocephalus
Surgery is the only treatment option for Hydrocephalus. A neurologist may suggest surgical insertion of a drainage system, called a shunt. In rare cases, Endoscopic third ventriculostomy surgical procedure may also be performed.
Tremor
A tremor can be described as a nervous system disorder that causes involuntary and rhythmic shaking. It can affect any part of the human body but generally occurs in the hands and makes simple tasks difficult.
Symptoms of tremor
Symptoms include shaking on one side of the body, shaking affecting one hand or hands, yes and no motion of the head, shaking may get aggravated by emotional stress, fatigue, caffeine or temperature extremes.
Treatment of tremor
A neurologist may prescribe beta blockers, anti-seizure medications, tranquilizers and onabotulinumtoxina (botox) injections for the treatment of a tremor. Additionally, he may suggest deep brain stimulation surgical procedure if patients fail to respond to medications.
Meningitis
Meningitis refers to an inflammation of the three membranes that cover the brain and spinal cord. Meningitis is usually caused by a viral infection, but bacterial and fungal infections are other causes.
Symptoms of Meningitis
Symptoms include sudden high fever, stiff neck, severe headache, headache with nausea or vomiting, difficulty concentrating, seizures, sleepiness, sensitivity to light, skin rash etc.
Treatment of Meningitis
For bacterial meningitis, a neurologist may prescribe intravenous antibiotics and corticosteroids to reduce the risk of brain swelling and seizures. Treatment of viral meningitis includes bed rest, drinking plenty of fluids and over-the-counter pain medications to help reduce fever.
Amnesia
Amnesia is described as a form of memory loss pertaining to facts, information and experiences. There can be many causes of amnesia, but prime factors include dementia or traumatic head injuries.
Symptoms of Amnesia
Symptoms include impaired ability to learn new information, impaired ability to recall past events, false recollections, confusion or disorientation.
Treatment of Amnesia
In order to treat amnesia, a neurologist will focus on the underlying cause of condition. Chemically induced amnesia is treated with detoxification. Amnesia from dementia is usually incurable and a neurologist may prescribe medications to support learning and memory.
Idiopathic intracranial hypertension
Idiopathic intracranial hypertension refers to a build-up of pressure around the brain which can be persistent and log-lasting. Why this medical condition occurs is not clear among neurologists.
Symptoms of Idiopathic intracranial hypertension
Symptoms include a constant throbbing headache, blurred vision, temporary loss of vision, feeling and being sick, drowsiness and irritability.
Treatment of Idiopathic intracranial hypertension
A neurologist may prescribe diuretics to remove excess fluid from the body, medicines to reduce the production of cerebrospinal fluid in the brain, steroid medication to relieve headaches and reduce the risk of vision loss. Additionally, surgical procedures such as shunt surgery and optic nerve sheath fenestration may be suggested if medicines fail.
Brain aneurysm
A brain aneurysm refers to ballooning in a blood vessel in the brain. It occurs when a weak spot in a human brain’s arterial wall bulges and fills with blood. It is a potentially life-threatening condition that can affect people of any age.
Symptoms of brain aneurysm
Symptoms include extremely severe headache, nausea and vomiting, stiff neck, double vision, light sensitivity, seizure, a drooping eyelid, loss of consciousness and confusion.
Treatment of brain aneurysm
Surgery is the only treatment option for brain aneurysm. A neurologist may suggest surgical clipping procedure to close off an aneurysm or an endovascular coiling procedure for the treatment of brain aneurysm.
Autism Spectrum Disorder
Autism spectrum disorder is a dangerous neuro-developmental disease which interferes with a child’s ability to communicate and interact. It also has a huge impact on behaviours, interests and activities of the suffering child. Autism spectrum disorder hampers a child’s social, occupational and other areas of functioning.
Symptoms of autism spectrum disorder
Symptoms include lack of facial expression, slurred speech, delayed speech, hesitation to start a conversation, speaking with an abnormal tone or rhythm, repetition of words, Development specific routines or rituals, unusually sensitive to light, sound and touch, uncooperative or resistant to change, constantly moving, having odd food preferences etc.
Treatment of autism spectrum disorder
The goal of treatment is to maximize a child’s ability to function by reducing the symptoms of Autism spectrum disorder. A neurologist may suggest behaviour and communication therapies, educational therapies, family therapies along with antidepressants and antipsychotic drugs for the treatment of autism spectrum disorder.
Diagnostic tests performed by neurologists
Lumbar puncture: It is performed by a neurologist to diagnose a problem in your nervous system that can be detected in your spinal fluid.
Tensilon test: This test is done by a neurologist to diagnose myasthenia gravis.
Electroencephalogram (EEG): This test is done by a neurologist to measure electrical activity in the brain.
Neurologists may also perform types of tests including sleep studies and angiography.
