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What is Neurology: An Overview

Definition and Overview

Neurology is a medical specialty focusing on the brain and nervous system. Doctors who specialize in the diagnosis and treatment of brain and nervous system disorders are called neurologists. There is a long list of neurological disorders that can affect individuals, with most of them causing memory problems and affecting a person's ability to perform his normal daily activities. Thus, these disorders tend to have a debilitating effect on a person's life, making neurological treatments a crucial part of their lives.

How are Neurological disorders diagnosed?

To diagnose a neurological problem, professionals rely upon certain tests:

  • Imaging studies namely CT scan and MRI – Magnetic resonance imaging (MRI) and computerized tomography (CT) focus on the brain and spinal cord region, as well as MRI angiography and CT angiography, which takes images of the blood vessels, are used to study the neurological system and detect problem areas. A carotid Doppler ultrasound may also be used to check the rate of blood flow going to the brain through the carotid artery.

  • PET testing – A PET scan can also be used to gather both genetic and molecular information about the brain and its activities. This is widely used to detect problematic areas of the brain as well as brain tissue that can still be salvaged. This means that a PET scan is helpful not only in identifying problems but also in slowing disease progression.

  • Electroencephalograms (EEG)

  • Nerve conduction studies or electromyogram (EMG)

  • Electroneurogram (ENG) – This is a diagnostic test used to measure the electrical activity of the brain's neurons, particularly those in the central and peripheral regions.

  • Eye movement analysis

  • Neuropsychological testing – This involves several paper tests that assess patients in terms of their attention, language, memory, reasoning, and learning.

  • Lumbar puncture – Also known as cerebrospinal fluid analysis, this test takes a small amount of fluid from the spinal canal for analysis.

  • Biopsy of skin muscle and nerves

  • Blood tests

Key treatments for Neurological disorders

There is a wide range of neurological treatments that neurologists incorporate into their patients' treatment plans to help them cope with their conditions. These fall into different categories such as medications, device-based therapy, physical therapy, surgery, and rehabilitation.

  • Deep brain stimulation
  • Radiotherapy
  • Angiographic procedures
  • Antiretroviral therapy
  • Brain mapping
  • Cyberknife
  • Gamma knife
  • Plasma exchange
  • Sensory therapy
  • Hormone replacement therapy


The treatments for neurological disorders are usually symptoms-based, which means that the same treatment may be used for different disorders that cause similar symptoms.

  • Movement disorders (Parkinson's disease, multiple sclerosis, dystonia, spasticity) – The common treatment for these conditions include deep brain stimulation, Botox injections to modify the nerve and muscle connection by inhibiting acetylcholine release, and oral and intravenous medications.

  • Stroke and cerebrovascular diseases – For these conditions, a mix of medications consisting of blood thinners, drugs to control blood pressure, and lipid control medications is used, together with angiographic procedures and radiotherapy. If tumors are present, surgery may be necessary.

  • Vestibular treatments – Since neurological conditions cause balance problems, vertigo, and motion sickness, vestibular treatments such as Epley maneuver are prescribed.

  • Neuromuscular disease – For neuromuscular diseases such as ALS, myopathy, neuropathy, and myasthenia gravis, treatments include topical and oral drugs, Botox injections, and rehabilitation therapy.

  • Cognitive disorder – Psychological therapies, medications, and counseling are used for disorders that cause cognitive decline.

Most common Neurological disorders

There is a wide range of neurological disorders. Some of the less common ones include Lou Gehrig's disease, dementia, down syndrome, Bell's palsy, autism, epilepsy, Guillain-Barre syndrome, meningitis, restless legs syndrome, stroke, encephalitis, narcolepsy, among several others.

The three most common neurological disorders are:

1. Multiple sclerosis

Multiple sclerosis is a disease of the brain and the spinal cord. The earliest symptoms include numbness, tingling, or weakness in certain parts of the body, as well as blurred vision. Progressive symptoms include muscle stiffness, urinary problems, and thinking problems. With early treatment, symptoms can be relieved and the progress of the disease can be delayed. Its causes are yet to be established although studies show possible links to environment, genetics, or viruses.

Living with and managing MS is possible with the help of a neurologist, who prescribes medications that suppress or alter the immune system's response and prevent it from attacking the myelin around the nerves. Neurologists may also suggest more advanced and sometimes invasive treatment procedures for MS sufferers in severe cases.

2. Alzheimer's disease

Alzheimer's disease is a common problem popularly known as the culprit behind memory loss in old age. However, aside from memory problems, Alzheimer's may also cause thinking and judgment disabilities. It is also not constrained by age; although it is more common among the elderly, there are early-onset cases of Alzheimer's.

The main symptoms of Alzheimer's include short-term memory loss, disorientation, difficulty performing daily tasks such as brushing teeth or washing hair, difficulty in recalling words for everyday use, and mood swings. In the middle stages of the disease, hallucinations and paranoia may occur. In the advanced stages, the disease may hinder an individual from communicating, recognizing other people, walking, swallowing, or smiling. It is a debilitating disease that can severely affect a person's quality of life.

There is no cure for Alzheimer's, but its progression can be delayed and its symptoms can be reversed temporarily with continuous treatment.

3. Parkinson's disease

Parkinson's disease is another very common neurological disorder wherein the nerve cells in the middle portion of the brain, which controls body movements, slowly degenerate. Symptoms include barely noticeable trembling or stiffness in the limbs, which worsens into tremors or shaking. Soon, balance and coordination also deteriorate. Cognitive decline and emotional problems soon follow. This disease is most common between the ages of 50 and 65."

Genetics is believed to be the main cause, although there are some cases where environmental toxins and viral infections also played a role.

When should you see a Neurologist?

If you experience recurrent symptoms, it is best to see your primary care doctor. If deemed necessary, he will recommend you to a neurologist. The usual symptoms of neurological disorders include:

  • Headaches that are more severe, continuous, recurrent, or comes with vomiting
  • Changes in vision
  • Chronic pain that's been bothering you for months or years
  • Weakness
  • Numbness
  • Problems with bladder or bowel control
  • Dizziness
  • Tingling
  • Movement problems or unintentional movements, such as jerks, tremors, clumsiness, and difficulty walking
  • Seizures
  • Memory problems
  • Confusion
  • Sleep problems


Take note that these symptoms can also be caused by disorders that are not neurological in nature. Thus, if your primary care physician cannot provide treatment for these problems, it is best to see a neurologist.

References:

  • University of Utah Health Care, Neurosciences Services: “Should You See A Neurologist?”
  • Mount Sinai Hospital: “Neurological Testing and Treatments.”
  • University of California San Francisco, Conditions and Treatments: “Neurological Disorders.”
  • Okun M. (2015). “Creatine ineffective against progression of Parkinson Disease.” The New England Journal of Medicine.
  • Francis P., Palmer A., Sims N. et al. (1985). “Neurochemical studies of early-onset Alzheimer’s disease – possible influence on treatment.” The New England Journal of Medicine.
  • Toro J. (2015). “Neuropathic pain therapy: Evidence-based recommendations.” The New England Journal of Medicine.
  • Yager J. (2015). “Predictors of progression to severity and death in Alzheimer disease.” The New England Journal of Medicine.
  • Yang F, Lagerros YT, Belloco R. (2014). “Physical activity and risk of Parkinson’s disease in the Swedish National March Cohort.” Oxford University Press.