A person should consult a neurologist if they are suffering from organic diseases of the brain, spinal cord, nervous system and muscles. Neurologists treat the person as a whole and assist patients suffering from chronic neurological diseases. A psychiatrist deals with any mental problems and abnormalities that may affect an individual’s mental state.
Typical neurological diseases
Training to become a neurologist takes six years and is concluded with the completion of a three-part specialist examination. Afterwards, the person may then opt to specialize even further. Typical neurological diseases include:
- Stroke and cerebral hemorrhages
- Multiple sclerosis
- Parkinson’s disease
- Impaired consciousness and memory disorders, dementia
- Headaches and migraines
- Sleep disorders
- Diseases of the nerves and nerve roots, such as carpal tunnel syndrome and intervertebral disk problems
- Restless leg syndrome
- Back pain
What are the signs that I should see a neurologist?
Discomfort in individual sections of the body, paresis, standing/gait instability, lapses in consciousness or unusual headaches are all reasons to be examined by a neurologist. A neurologist should also be consulted if a person is experiencing migraines, back pain or other chronic pain. It should be noted that individuals may experience or perceive very different symptoms.
Dizzy spells, changes in hearing and speech, vision loss – neurological symptoms can affect all of the body’s sensory organs. Trembling, muscle stiffness, muscle weakness and back pain radiating into the legs and arms should be examined.
The onset of dementia can manifest itself in the form of confusion, increasing forgetfulness, loss of one’s everyday capabilities and behavioral changes. In the early stages, the patient experiences short-term memory problems and disorientation. Sufferers often have a tendency to withdraw to hide the weakness.
What is the role of the neurologist?
The patient’s symptoms are discussed in detail (documenting their medical history) for the purposes of an overall evaluation. During a head-to-toe clinical neurological examination, the neurologist looks for external symptoms and tests nerve reflexes, paying attention to the person’s gait and posture to determine whether there is a disorder affecting the person’s ability to balance. The examination also helps identify changes in the skin and muscles, as well as injuries (falls).
Humans have 12 cranial nerves. The functioning of these nerves may be impaired in the case of brain diseases, injuries or inflammation. Because each cranial nerve has a very specific function, they can be examined using functional tests (smell, taste, vision, sound, facial muscles…). During a neurological examination, the doctor will also regularly test the person’s mental and psychological capacities. A memory test may also be performed if there appear to be any abnormalities.
Depending on the results, additional diagnostics may be performed, including lab tests of blood and urine, or taking a sample of cerebrospinal fluid from the spinal canal (lumbar puncture).
- NCV: Measuring nerve conduction velocity
- EEG: Measuring brain waves (electroencephalography)
- EMG: Measuring muscle activity (electromyography)
- Evoked potentials: Every sensory stimulus in the body triggers brain activity that can be measured.
- Doppler and duplex sonography: Ultrasound examinations of the vessels and brain
- CT, MRI, PET: additional brain imaging methods
- Dementia testing
After carrying out the necessary examinations for the individual case, it is usually possible to diagnose one of the aforementioned neurological diseases as the cause.
If, for example, it is found that the cause is a circulatory disorder in the brain (stroke), this will also require a regular monitoring of risk factors and the cerebral vessels (ultrasound) in the course of further treatment (usually with medication).
The procedure is the same if, for example, multiple sclerosis is diagnosed as the cause of the symptoms. Once acute treatment has been started, regular clinical and follow-up checks with imaging as well as further preventative treatment are necessary.
Swiss Neurological Society
For more information on the field of neurology (in German and French), visit the website of the Swiss Neurological Society (SNG) here: www.swissneuro.ch.