What is a Neurologist?
A neurologist is a medical doctor who specializes in the diagnosis, treatment and management of illnesses that affect the brain, spine and nervous system.
Medical conditions that are treated by neurologists include:
- Amyotrophic lateral sclerosis - ALS ("Lou Gehrig's Disease")
- Alzheimer's Disease and other forms of dementia, such as Lewy Body dementia and multi-infarct dementia
- Brain and spinal cord injuries, such as traumatic brain injury (TBI)
- Brain cancer or other cancers that have spread to the brain, leading brain tumors and spinal cord tumors
- Epilepsy and other seizure disorders
- Headache and other cluster headaches, migraine headaches, and tension headaches.
- Multiple Sclerosis
- Movement disorders, such as Parkinson's Disease, Restless Leg Syndrome (RLS), and focal dystonias (cervical dystonia, blepharospasm).
- Sleep Disorders, including insomnia, excessive daytime sleepiness (EDSS) and narcolepsy
- Tremor (shaking), including essential tremor
- Stroke and the rehabilitation of side effects resulting from stroke
A neurologist completes at least three years of specialized neurological training after graduating from medical school and completing a medical internship. Many neurologists complete additional training in neurology subspecialties, such as stroke, epilepsy, neuromuscular disease, and movement disorders.
The United Council for Neurologic Subspecialties recognizes 8 neurology subspecialties
- Autononomic Disorders
- Behavioral Neurology or Neuropsychiatry
- Clinical Neuromuscular Pathology
- Geriatric Neurology
- Headache Medicine
- Neurocritical care
Other areas in which neurologists may specialize include chronic pain, sleep and stroke.
What Do Neurologists Do?
Neurologists diagnose complex neurological diseases by obtaining a detailed health history of the patient, and performing a detailed neurological exam to assess a person's mental status, vision, strength, coordination, reflexes, and sensation.
Additional diagnostic tests may be ordered and interpreted by the neurologist. These include
Head CT (Computerized Tomography of the head). The CT scan 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.
EEG (Electroencephalogram). 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. A neurologist may order this on patients who have had a seizure.
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.
Lumbar Puncture (LP). During this test, the lower back is numbed with local anesthesia and a thin needle is placed into the space that contains the spinal fluid (CSF). A neurologist may recommend this test to check for bleeding, hemorrhage, infection, or other disorder of the brain, spinal cord. Discomfort may be associated with this test.
Head MRI (Magnetic Resonance Imaging). An MRI used magnetic fields and radio waves to take images of the brain. It is a harmless test performed while 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).
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.
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.
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. A neurologist may order this on patients who have had a stroke or are at risk of developing a stroke.
Neurologists can recommend surgical treatment, but they do not perform surgery. When surgical treatment of a medical condition is recommended, the neurologist works closely with a neurosurgeon who performs the procedure.
Professional Organizations of Neurologists
Neurologists may belong to the American Academy of Neurology (AAN). The American Academy of Neurology is an international professional association of neurologists and neuroscience professionals dedicated to providing the best possible care for patients with neurological disorders. Some members of the Academy who have demonstrated special achievement in neuroscience may be called "Academy Fellows". Academy Fellows may be designated by the "FAAN" suffix following their name.
Other professional organizations in which neurologists may be members for ongoing subspecialty education and research efforts include the American Epilepsy Society, American Headache Society, and the Movement Disorder Society.