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. Neurologists do not perform surgery.
What Does a Neurologist Treat?
- Common neurologic disorders include:
- Amyotrophic lateral sclerosis
- Migraine and other
- Alzheimer's disease and other
- Brain and spinal cord injuries
- Multiple Sclerosis
- Brain tumors
- Parkinson's disease
How are neurologic disorders diagnosed ?
An accurate diagnosis is the first step toward effective treatment. Diagnosis involves getting a detailed health history of the patient, and neurologic tests for mental status, vision, strength, coordination, reflexes, and sensation. Sometimes, further tests are needed to reach a diagnosis.
- Some common neurologic tests are:
- Computerized tomography or computer-assisted tomography (CT or CAT scan)
- Magnetic resonance imaging (MRI)
- Transcranial Doppler (TCD)
- Electroencephalogram (EEG)
- Electromyogram including nerve conduction study (EMG)
- Evoked potentials
- Sleep studies
- Cerebral spinal fluid analysis (Spinal Tap or Lumbar Puncture)
Computerized Tomography or Computer Assisted Tomography (CT of CAT scan). 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.
Transcranial Doppler (TCD). This test uses sound waves to measure blood flow in the vessels of the brain. A microphone is placed on different parts of the head to view the blood vessels. This test is painless.
Neurosonography. This test uses ultra high frequency sound wave to analyze blood flow and blockage in the blood vessels in or leading to the brain. This test is painless.
Electroencephalogram (EEG). 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.
Electromyogram (EMG). 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.
Evoked Potentials. 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.
Sleep Studies. 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.
How are neurologic disorders trated?
Treatments are available for many neurologic disorders, both for acute and long-term management. Treatments are different for each condition. Before exploring treatment options, your neurologist will perform and interpret tests of the brain or other parts of the spinal cord to first arrive at a correct diagnosis. Treatment can help people with neurologic disorders maintain the best possible quality of life.
Preparing for an Office Visit for Neurologist
Diagnosing and managing your neurologic disorder is a partnership between you and your neurologist. Much of this partnership relies upon sharing your health information.
You want your doctor to know all about your symptoms, medical history, and any prior test results. This way he or she can be more effective in diagnosing and treating your disorder.
Likewise, you want to get answers to your questions so that you and your loved ones can better understand the disorder and treatments, and how they will affect your daily life.
- You can get the most out of your doctor visit if you are fully prepared. Most people visiting a neurologist want and need to have the following questions answered:
- What type of disorder do I have?
- How will this disorder affect my health?
- What is the treatment and what will it do?
- How will this disorder affect my daily life and activities?
When answering these questions, you and your neurologist will be exchanging a lot of information. It often helps to have a family member or friend with you to listen, take notes, or ask questions.
You might think about your visit with the neurologist as having several stages. During each stage there are actions which can help you be prepared.
Even if you have already met with your neurologist, these tips can be helpful for future visits or if you are referred to other medical specialists.
Pre-visit Planning Activities
- Write down the questions you would like to ask. List the most important questions first. It might be helpful to get a small spiral-bound notebook or folder to keep these questions and answers in one place and so you can add information or questions throughout your treatment.
- Ask a relative or friend to come with you to the visit. A second set of ears may be helpful.
- Gather all your medications in a bag to bring to your visit. Or write down in your notebook their names, dosage, and how often and what time you take them. Be sure to include supplements and over-the-counter medications.
- Prepare your "health history" (previous illnesses, hospitalizations, allergies, etc.) and bring it to the visit. You may want to ask your neurologist if there is a form you can complete prior to the visit. You may also want to bring your family members' health histories. Their health information may help the neurologist diagnose your condition.
- Bring other medical information and test results, such as lab work, x-rays, and MRIs. For radiological studies, ask the office if they prefer copies of the films or if reports are adequate. You may also ask your primary doctor to send records directly to your neurologist's office.
- Bring a list of the doctors you want your neurologist to update about your medical condition. Be sure to include their telephone, fax numbers, and addresses.
- Bring your insurance card and referral, if needed.
At the Office
- Plan to arrive early to complete any forms that may be needed. If you do not understand the questions or forms, ask for help—it is your right to have information explained to you.
- Give the neurologist any information about your symptoms or condition, even though you may feel that it may be unimportant or embarrassing.
- Take notes or have your companion take notes on what the neurologist tells you. If you don't understand the doctor, don't be afraid to ask for more information.
- Ask the doctor the questions you wrote out during your pre-visit planning activities, even if you may feel the questions are not important.
- Ask for handouts or Internet information that you can share with your family or review when you are at home.
- Make a follow-up appointment, if necessary.
- Find out when your neurologist will get back to you with your test results.
- Know what the next steps are in your care.
- If your neurologist prescribes medication, make sure you fully understand:
- What has been prescribed and what it should do for you
- If there is a generic substitution that is acceptable
- Exactly when and how long you are to take your medication(s)
- The potential side effects of the medications and what to do if they occur
- Back at Home
- Review the information you got from the neurologist's office. If you can't remember or don't understand something you were told, call the office to get the information you need.
- Follow the neurologist's instructions. Managing your disorder is a partnership between you and your neurologist.
- Make sure any medication you get at the pharmacy or through your mail order pharmacy benefits plan is what has been prescribed for you.
- Call your neurologist's office if:
- There are any complications or changes in your condition
- You experience any side effects from the medications
- You need to follow up on your test results
The American Academy of Neurology website for patients and caregivers offers a wealth of articles, information about events and resources, and links to support groups, clinical trial information, and more.
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