A physician who specializes in diagnosing and treating diseases and disorders of the nervous system

WHEN SHOULD I WORRY ABOUT...

Jan. 24, 2020

If you or a loved one has unexplained symptoms that could be related to the brain or nervous system, your doctor may recommend a neurological exam with a specialist.

Neurologists are specialists who treat diseases of the brain and spinal cord, peripheral nerves and muscles. Neurological conditions include epilepsy, stroke, multiple sclerosis (MS) and Parkinson's disease.

Dr. Nhu Bruce, neurologist at Houston Methodist, also commonly sees patients for:

• Uncontrolled headaches
• Memory loss
• Imbalance
• Numbness and pain

If you're experiencing these symptoms, you probably have a lot of questions.

Common reasons to visit a neurologist

"A thorough neurological exam is the most important tool I have as a neurologist," Dr. Bruce explains. "It can help differentiate and localize the causes of common complaints."

Dr. Bruce says these are the six signs that it is time to visit a neurologist.

Chronic or severe headaches

If you get migraine headaches, you should probably make an appointment with a neurologist, especially when the symptoms are associated with neurological deficits or tried treatments prove ineffective.

Chronic pain

When pain is chronic, and your primary care doctor can't help you manage it, you should consider a referral to a neurologist because there could be another underlying reason for the symptoms.

Dizziness

Experiencing vertigo (feeling like you're spinning) or having difficulty keeping your balance could be a sign of something more serious.

Numbness or tingling

Numbness or tingling, especially when it occurs on one side of the body or comes on suddenly, could be a sign of a stroke or other serious condition.

Movement problems

Difficulty walking, shuffling your feet, tremors and unintentional jerks, can all be signs of a nervous system problem.

Memory problems or confusion

Worsening memory problems, personality changes or mixing up words could be signs of Alzheimer's disease.

What to expect during a neurological exam

A neurologist can help identify the cause of symptoms and create a treatment plan for both common and complex neurological conditions.

During a neurological exam, instruments, such as lights and reflex hammers, may be used to assess the nervous system. Motor skills, balance, coordination and mental status may also be tested.

Multiple sclerosis (MS) is an example of a complex condition that may be best treated by a neurologist.

"MS has various forms, and the treatment options have changed significantly over recent years," Dr. Bruce says.

Patients can benefit from the expertise of a neurologist who is familiar with the latest research and treatment options for MS and other neurological conditions.

Next Steps:

• If you're ready to schedule an appointment, find a neurologist near you >

Of all the systems in the body, damage to the nervous system can be (arguably) the most devastating. And while the inner workings of the nervous system are complex and involved, neurologists have devoted their lives to understanding it.

What is a neurologist?

A neurologist is a medical doctor that specializes in the study, diagnosis, treatment, and management of injuries, diseases, and disorders of the nervous system. The nervous system includes the brain and spinal cord and is made up of two parts: the central and peripheral nervous system. Illnesses, disorders, and injuries that affect the nervous system often require a neurologist’s treatment.

Training

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. Because the nervous system is so complex, it is common for neurologists to pursue additional education in a subspecialty.

Subspecialties

When a neurologist elects to specialize, they do so by completing a fellowship in that area. Some common specialties include:

• Headache medicine
• Neuromuscular medicine
• Neurocritical care
• Neuro-oncology
• Geriatric neurology
• Autonomic disorders
• Vascular (stroke) care
• Child neurology
• Intervention neuroradiology
• Epilepsy

Role

Neurologists are principal care providers when a patient has a neurologic disorder that requires frequent care. Neurologists commonly assume a consulting role for primary care physicians in the case of stroke, concussion, or headache. Neurologists do not perform surgery, but may refer patients requiring surgery to a neurosurgeon or spine surgeon. In the case of surgery, a neurologist may continue to monitor and supervise treatment.

What conditions do neurologists treat?

Disorders

A neurologist treats disorders of the central and peripheral nervous system, including the brain, spinal cord, cranial nerves, peripheral nerves, nerve roots, autonomic nervous system, neuromuscular junction, and muscles.

Common disorders of the nervous system include:

• Epilepsy: A neurological disorder associated with abnormal electrical activity in the brain, causing recurrent, unprovoked seizures and loss of consciousness.
• Alzheimer’s disease (and other dementias): Progressive mental deterioration that is caused by generalized degeneration of the brain.
• Stroke (and other cerebrovascular diseases): A stroke occurs when a blood vessel is prevented from delivering oxygen and nutrients to the brain, due to a blood clot or rupture.
• Migraine (and other headache disorders): A severe, reoccurring headache often paired with nausea and disturbed vision.
• Multiple Sclerosis: A chronic disease involving damage to nerve cells in the brain and spinal cord characterized by numbness, speech and muscular impairment, blurred vision, and severe fatigue.
• Parkinson’s disease: A progressive disease marked by tremor, muscular rigidity, and slow, imprecise movement. It is associated with degeneration of the basal ganglia of the brain, and dopamine deficiency.
• Brain tumors: A mass of abnormal cells in the brain, leading to impaired cognitive function.
• Brain trauma (and other injuries of the nervous system): Injury to the brain from an outside force, sometimes leading to an altered state of consciousness, and permanent or temporary impairment of cognitive, physical, or psychosocial functions.
• Tourette’s Syndrome (and other disorders of function): A neurological disorder, coupled with involuntary tics and vocalizations, as well as the compulsive exclamation of obscenities.
• Amyotrophic Lateral Sclerosis (ALS, Lou Gehrig’s Disease) A progressive deterioration of the motor neurons of the central nervous system, leading to muscular atrophy and paralysis.

Diseases

A Neurologist will treat diseases that attack the nervous system, such as:

• Infections (bacterial, viral, fungal)
• Cancers (malignant, benign,)

Neurological diseases and disorders are common, and the risk of developing one increases with age. Neurologic disorders, such as injury of the nervous system, are also a common occurrence. Research shows that as many as 60 million people worldwide may suffer a traumatic brain injury each year. It is important to know the signs of neurological diseases and disorders, as they are serious and may be life-threatening when left untreated.

Symptoms

Your primary care physician may refer you to a neurologist if you are experiencing one or more of the following symptoms:

• Headaches
• Chronic pain
• Dizziness
• Numbness or tingling
• Weakness
• Movement problems
• Seizures or loss of consciousness
• Vision problems
• Memory problems or confusion
• Sleep problems
• Speech or language difficulties

People who are having problems with their senses such as vision, smell, or touch, may also be referred to a Neurologist, as sensory dysfunction is sometimes caused by disorders of the nervous system.

Procedures

If your primary care physician refers you to a Neurologist, here’s what you can expect. During your first appointment, a Neurologist will likely ask you to participate in a physical exam and neurological exam. Neurological exams are tests that measure muscle strength, sensation, reflexes, and coordination. Because of the complexity of the nervous system, you may be asked to undergo further testing.

Neurological testing

Common types of neurological testing include:

• Lumbar puncture: A neurologist will only recommend this if they believe that the cause of your symptoms may be detected in your spinal fluid. In this procedure, the area is numbed and sterilized. A needle is then inserted into the lower spine to withdraw a sample of spinal fluid.

• Electroencephalogram (EEG): Electrodes are applied to the scalp to measure the electrical activity in the brain.

• Electromyography and nerve conduction studies (EMG/NCS): Electrodes are used on the skin and extremely fine needles are placed in the muscle to measure the function of nerves and muscles.

Other common testing includes CT, MRI, and PET scanning. Other diagnostic procedures include sleep studies and angiography (identifying blockages in blood vessels).

If you or a loved one experiences symptoms of a neurological disorder, schedule an appointment with your primary care physician and ask about making an appointment with a neurologist at WWMG.

What is a specialist in diagnosing and treating disorders of the nervous system?

What is a neurologist specialist called?