Working with Your Doctor
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.
A neurologist's training includes an undergraduate degree, four years of medical school, a one-year internship, and at least three years of specialized training. Many neurologists also have additional training in other areas—or subspecialties—of neurology such as stroke, epilepsy, neuromuscular disease, and movement disorders. These are some of the more common subspecialties within the field of neurology.
What Does a Neurologist Treat?
Common neurologic disorders include:
What is the Role of a Neurologist?
Neurologists are principal care providers, consultants to other doctors, or both. When a person has a neurologic disorder that requires frequent care, a neurologist is often the principal care provider. People with disorders, such as Parkinson's disease, Alzheimer's disease, seizure disorders, or multiple sclerosis may use a neurologist as their principal care doctor.
In a consulting role, a neurologist will diagnose and treat a neurologic disorder and then advise the primary care doctor managing the person's overall health. For example, a neurologist may act in a consulting role for conditions such as stroke, concussion, or headache.
Neurologists can recommend surgical treatment, but they do not perform surgery. When treatment includes surgery, neurologists may monitor the patients and supervise their continuing treatment. Neurosurgeons are medical doctors who specialize in performing surgical treatments of the brain or nervous system.
Diagnosis and Treatment of Neurologic Disorders
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.