Neurology
Overview
Neurology is the branch of medicine that deals with the study and treatment of nervous system disorders. The nervous system itself is composed of the central nervous nervous system and the peripheral nervous system. The central nervous system is the brain and the spinal cord, while the peripheral nervous system is composed of all the other nerves and sensory receptors in the sense organs (such as the eyes, ears, skin etc.).
A doctor who specialises in neurology is called a neurologist, and surgeons who perform surgeries related to neurology are called neurosurgeons.
Why should you see a neurologist?
You may need to consult a nephrologist if you are facing organic conditions of the brain, spinal cord, muscles, and the nervous system. Neurologists assist the patients by examining the signs and conditions that have affected their mental state.
Here are six signs that tell it is time to visit neuro specialty hospital:
Chronic headaches
If you have migraine pain, you should probably make an appointment with a neurologist especially if the symptoms are associated with neurological disorders.
Chronic pain
When pain in your muscles prolongs for more than 10 weeks and your primary care cannot help manage it, you should consider visiting a neurologist.
Dizziness
Vertigo(feeling like your head is spinning) or having difficulty keeping your balance could also point to some serious neurological disorder.
Numbness or tingling
Numbing or tingling sensation on one side of the body for a prolonged time that often comes and goes suddenly can be because of a stroke or some serious condition.
Movement condition or imbalance
Difficulty walking because of imbalance or staggering and unintentional jerks all shows up some serious neurological disorders.
Confusion
Loss of memory or personality changes or fumbling could be a sign of Alzheimer's.
Why NH?
Cerebral stroke or 'Brain Attack' is the leading cause of disability and probably the third leading cause of death in India. At Narayana Health, we use a new technique known as a temporary endovascular bypass. There are interventional neurological procedures, which are used for the treatment of acute stroke or epilepsy and are practised abroad very routinely. We hope to increase awareness of stroke and its prevention so that the focus is on prevention rather than cure.
The network of hospitals under Narayana Health offers comprehensive packages for epileptic care services, cerebral stroke programmes including rehabilitation and evaluation of complex neuromuscular disorders for which a recommended course of neurological disorders treatment is followed.
Our neurologists are experienced in treating patients with neurological disorders and diseases including:
- Autism, learning disabilities
- Epilepsy, dizziness and fainting
- Chronic tension or stress-related headache, migraine
- Persistent backache and spine problems
- Short-term memory loss and dementia
- Parkinson's disease, cerebral stroke
- Cancers and tumours
- Meningitis or brain fever
- Sleep apnoea, semi-somnia, insomnia (sleep disorders)
- Nerve-related issues (stress and nervous tensions) and trauma cases
Types of Neurology Diseases
Neurological disorders and diseases are caused by problems in either the central or peripheral nervous systems, or both. They can affect one, or many parts, of the nervous system such as the brain, spinal cord, nerves, nerve roots, neuromuscular junctions, the autonomic nervous system, and so on.
The causes of neurological disorders are varied. They can be caused by faulty genes, injuries, malnutrition, infection, or a response to an infection. Narayana Health is the best neurology hospital in India to treat all types of neurological disorders. There are more than 600 types of neurological diseases and disorders, but they can be broadly classified as follows-
- Problems at the developmental stages of the nervous system such as spina bifida.
- Genetic diseases such as muscular dystrophy and Huntington’s disease.
- Degenerative or demyelinating diseases that cause the cells of the nervous system to die, or get damaged, over time such as Parkinson's disease and Alzheimer's disease.
- Problems with the blood supply to the brain causing cerebrovascular disease such as a stroke.
- Memory loss and dementia
- Spinal cord disorders
- Speech and learning disorders
- Headache disorders such as migraines
- Seizures
- Pinched nerves
- Tremors or uncontrolled movements
- Cancers
- Infections
- Sleep disorders
Diagnosis
During the first meeting with a neurologist at Neuro Hospital, you will be undergoing a physical examination to look for any abnormality in speech, vision, cognitive abilities, coordination, strength, sensation and reflexes. Subsequently, diagnostic tests will be prescribed if required to better study and confirm the neurological problem if any.
At Narayana Health, the best neuro hospital in India, the most commonly prescribed tests for neurological disorders are
Imaging tests
Modern imaging techniques use different methods to obtain and study images of tissues within the body, in order to diagnose various problems. The most commonly used imaging techniques to diagnose neurological problems are Computed Tomography (CT or CAT), Magnetic Resonance Imaging (MRI), Positron Emission Tomography (PET) and Single-Photon Emission (SPECT) scans. These scans help the neurologist to clearly observe and diagnose strokes, injuries, tumours, malformation or haemorrhage of blood vessels or abnormalities during the development of the brain.
- Computed Tomography (CT): CT scans are extensively used to obtain two-dimensional images of the internal structures of the body. It involves the injection of a contrast dye into the bloodstream of the patient to help visualise the images better. A CT scan of the brain can be used to easily detect any structural abnormalities, strokes, haemorrhages, bone or blood vessel malformations or damage, amongst other disorders. Spinal CT scans can be used to diagnose problems such as a spinal fracture, herniated disc, or narrowing of the spinal canal. CT scans should be avoided by pregnant women as they involve radiation and may be harmful to the fetus. These scans are preferable for those patients who are unable to undergo an MRI scan.
- Magnetic Resonance Imaging (MRI): This type of imaging uses a very powerful magnetic field and radio waves to obtain images of the body. In addition to showing images, it can also be used to measure the flow of blood as well as mineral deposits. A contrast dye may be injected to improve imaging. MRI scans are usually used to diagnose multiple sclerosis, brain damage, inflammation, infection, structural abnormalities, damage and degeneration. Since an MRI’s magnetic field works on the water molecules in the tissues, it can be used to clearly study the water content and properties of different tissues. It’s important that there be absolutely no metal on the patient as the metal will be attracted by the magnetic field. People with implanted devices or infusion devices must be especially cautious to avoid MRIs. MRIs are much safer than CT scans because there is no radiation used.
- Functional MRI (fMRI): Blood has its own magnetic properties. fMRI uses these unique properties of blood to obtain images of the blood flow to different areas of the brain. This gives neurologists a tool by which they can study and pinpoint the areas of the brain that are activated for different functions and also study how long they stay active. This helps to localise the regions used for different functions before surgery, degenerative disorders and head injuries.
- Positron Emission Tomography (PET): PET scans are used to produce images that are more detailed than a CT or MRI scan. PET scans produce two and three-dimensional images using radioactive isotopes that are called tracers injected into the bloodstream. These scans are used to study tumours, blood flow, tissue metabolism, diseased tissue, as well as brain changes. Different compounds can be used to study multiple functions of the brain simultaneously.
- Single Photon Emission Computed Tomography (SPECT): This is a nuclear imaging test that also uses radioactive isotopes similar to those used in PET scans. It is used as a followup to other scans to diagnose neurological problems such as infections, tumours, degenerative diseases, spine disease, stress fractures and the areas of the brain that are involved in seizures. A Dopamine Transporter Imaging With Single-photon Emission Computed Tomography (DAT-SPECT) scan is another type of SPECT scan that is particularly used to diagnose Parkinson disease.
Blood And Urine Tests
Blood and urine tests are used by neurologists to detect the presence of toxins, as well as, infections and protein disorders.
Electroencephalogram (EEG)
EEG is a test that is used to study and record the electrical patterns generated in the brain. This is achieved by placing electrodes on the scalp to detect electrical patterns. EEG is useful in diagnosing epilepsy, seizures, injuries, headaches, dizziness, tumours and sleeping disorders; this test is also used to confirm brain death.
Electromyogram (EMG)
EMG is a test that is used to evaluate communication levels between a specific nerve and the muscle that it controls. This is achieved by the placement of electrodes on the skin’s surface or through a needle.
Electronystagmography (ENG)
This is a set of tests that are designed to diagnose neurological problems that cause dizziness, balance issues, and involuntary eye movements. Small electrodes or infrared photography is used during these tests.
Polysomnogram
This is a test that is used to monitor the activity of the body and the brain when the patient is asleep. It involves placing electrodes to the patient's eyes, scalp, and chin to record brain waves. The person's heart rate, breathing, eye movements, and other body movements are also recorded to diagnose sleep disorders.
Evoked Potentials
Evoked potentials are the tests that are used to study and determine the reaction and response of the brain to specific stimuli. The equipment is similar to that used in an EEG.
Spinal Tap or Lumbar Puncture
When a neurologist needs to study the cerebrospinal fluid for infection, blood or any other abnormalities, a spinal tap or lumbar puncture is performed. This involves extracting a small amount of the spinal fluid to be examined in the laboratory.
Nerve or Muscle Biopsy
A biopsy of nerve or muscle tissue is performed in patients with neuromuscular disorders. Muscle samples are usually removed surgically or through a thin hollow needle. Nerve samples are removed through an incision. Sometimes skin biopsies are required to test for metabolic disorders or for the measurement of the small nerve fibres present in the sample. Certain infections or tumours in the brain are tested through a biopsy where the sample is retrieved through a surgical procedure.
Ultrasound Imaging / Ultrasonography
This test uses high-frequency sound waves to get images of the body. It is usually used to assess a fetus or a newborn for any neurological problems, such as hydrocephalus. Ultrasounds are also useful in studying the blood flow in specific areas of the body. The carotid Doppler ultrasound studies the blood flow in the blood vessels within the neck, while the transcranial Doppler ultrasound studies the blood flow in blood vessels within the skull. These studies are particularly useful in patients who are being assessed for risk of stroke.
Treatment & Preventions
Most neurological problems are not preventable. However, the ones that are avertible can be prevented by maintaining a healthy lifestyle; this means you should have a balanced diet. Keeping your fat intake to the minimum ensures that the blood vessels don’t get clogged. Avoiding bad habits such as drinking and smoking, along with leading an active lifestyle supports overall good health. Regular medical checkups are important to catch any problems early. When there are underlying health conditions such as high blood pressure and diabetes, they should be managed under medical supervision. When a person has been diagnosed with a neurological disorder, it should be treated under medical supervision, and in conditions such as epilepsy, measures should be taken to prevent further episodes.
Here are some of the significant neurology specialities at Narayana Hospital that offer excellent patient treatment services:
Interventional Neurology
Interventional neurology is a speciality which uses minimally invasive and image-based technologies procedures for the diagnosis and treatment of diseases of blood vessels of the brain and spinal cord (neurovascular diseases). These kinds of neurological diseases include paralytic strokes, brain aneurysms and arteio-venous malformations (AVM’s) of blood supplying the brain and spinal cords using coiling, stenting and embolization. Stroke “Brain attack” is the rapidly developing loss of brain functions due to the disturbance in the blood supply to the brain. Stroke is one of the leading causes of disability and death in India. India will face an enormous socio-economic burden to meet the costs of rehabilitation of "Stroke victims" because the population is now surviving through the peak years of the occurrence of stroke. Stroke is a treatable and preventable disease.
An interventional neurologist is specially trained to perform minimally invasive procedures for the treatment of conditions like aneurysms, strokes, spinal compression fractures and other complex diseases of the brain, neck and spine. Depending on your medical condition, they may order one or more of the following procedures.
- Angiogram and venogram
Angiogram and venogram are a type of X-rays, which are used to identify any blockages in the blood vessel and other problems associated with it. The procedure involves advancing a tiny tube in the vein or artery and injecting a dye through it. This enables the doctor to monitor blood flow.
- Angioplasty and Stenting
These procedures are followed to open narrowed or blocked blood vessels that lead to the spine or brain. A `thin tube is used in the procedure. It holds a guidewire with a tiny deflated balloon in it. The guidewire is advanced through the blood vessel until it reaches the blockage. The balloon is then inflated to remove the blockage and open the blood vessel. Sometimes, a small, metal mesh tube called a stent is used to open the blood vessel permanently.
- Catheter Embolization
Through catheter embolization procedure, the blood supply to an unhealthy tissue in the brain or spine (such as a tumour) can be rerouted or completely stopped. It can be carried out by placing a glue-like fluid or coil in the blood vessel.
Neuro Rehabilitation
Recognizing the need to rehabilitate patients with neurological/spinal injuries or disorders into mainstream life, Narayana Health has a specially designated department to take care of those who need counselling, care and routine check-up. The objective of this department is to improve a patient's quality of life in case of a traumatic case history or simply provide handholding and offer support services until the individual can manage his life smoothly. The path to recovery is then a quick and smooth process.
Some of the conditions that can benefit from a neurological rehab centre are as follows.
- Trauma by injury to the brain or spinal cord
- Vascular disorders like haemorrhagic strokes, ischemic strokes, subdural haematoma and transient ischemic attacks
- Structural or neuromuscular disorders, such as cervical spondylosis, bell palsy, brain or spinal cord tumours, carpal tunnel syndrome, myasthenia gravis, peripheral neuropathy and Guillain-Barré syndrome.
- Infections, such as meningitis, polio, encephalitis and brain abscesses
- Degenerative disorders like multiple sclerosis, Alzheimer’s disease, Parkinson’s disease, Huntington chorea, etc.
Neurology FAQ's
What does neurology mean?
Neurology is the medical field that deals with nervous system disorders. It takes on the treatment and diagnosis of diseases that involve the central and peripheral nervous system this includes the brain, nerves, and the spinal cord. It also includes coverings, effector tissues, blood vessels, and major muscle groups. Neurologists are generally consulted to treat cerebrovascular diseases such as Stroke, Multiple sclerosis, Parkinsons, Alzheimers, Lou Gehrigs disease, Epilepsy, and other speech and language disorders,
What does a neurologist treat you for?
A neurologist is a medical professional who focuses on treating diseases that affect the nervous system. The human nervous system is divided into two parts central and peripheral, which is inclusive of the brain and spinal cord. They are responsible for diagnosing, managing, and treating your neurological disorders.
Why would you be referred to a neurologist?
Firstly, you should consult with your primary care doctor to confirm your symptoms, they will recommend you to a neurologist; this is done when the symptoms are intense, and it needs immediate attention from a specialist.
Some of the prevalent diseases in neurology include Alzheimers disease, Parkinsons disease, severe migraines, strokes, epilepsy, and movement disorders. The reason youre referred to a neurologist is that they will inquire about your medical history to analyze your symptoms better and conduct physical exams on your brain/nerves. This will help them diagnose and manage your condition in the best way.
What are the signs and symptoms of neurological disorder?
Some of the common symptoms of neurological disorders are as follows:
- Weak muscles
- Dizziness
- Decreased mobility
People who begin to experience problems with touch, smell, or eyesight, may need to see a neurologist as soon as possible. These problems usually signal to a deeper issue that can be connected to your nervous system.
What are the signs and symptoms of neurological disorder?
A neurological disorder can have an intense impact on the patients life. Therefore, its important to get yourself checked when you experience the following signs and symptoms:
Pain:
This is a common symptom in neurological disorders, and it can be easy to overlook it. However, as you keep ignoring the pain, it will get more intense and unbearable. The chronic pain can be related to age as well, so its best that you dont overlook this sign and get it checked.
Experiencing trouble with memory:
Lack of concentration power and difficulty with memory are symptoms that a person may have a progressive disease like Amnesia or Alzheimers.
Feeling numb:
This is another symptom of a neurological disorder, that is, complete or partial loss of sensation. Here, the person wont be able to experience vibration, pain, or temperature. This also leads to difficulty with balance, coordination, walking, or doing any other physical activity. If this issue is persistent, then you have to visit a doctor immediately.
In addition to these, you may also suffer from partial or complete paralysis, seizures, a decline in cognitive abilities, unexplained pain and a decreased alertness or situational awareness.
What are the most common neurological disorders?
Alzheimers and Dementia: These are the most common neurological issues, and they affect the persons memory and cognitive process. These diseases mostly occur due to aging and are progressive, however, there are treatments that can help with improving the patients quality of life.
Epilepsy: This disorder takes place due to the irregular electrical activity in the brain, which leads to seizures.
Stroke: This happens when the brain doesnt receive enough blood and nutrients, which can lead to severe brain damage.
Parkinsons disease: This is a neurological disease that affects the motor system of the human body and takes place due to the lack of dopamine-producing cells. The patient can experience tremors and impaired coordination and balance.
What tests does a neurologist do?
Neurologists will make use of several varieties of diagnostic tests so that they can identify the nature of your disease, injury, or condition. The results will help them plan treatments and also manage the symptoms. Some of the common tests performed by neurologists are Brainstorm Auditory Response Test, Carotid Duplex, Cerebral Angiography, Computed Tomography, Doppler Ultrasound, and so on.
Why Do I Need A Blood Test Before An MRI?
In cases where a contrast dye must be injected to improve the imaging, a contrast agent called gadolinium is used. This material can be harmful to patients who suffer from kidney disease. This is why a kidney function test is conducted before an MRI to determine if the patient has normal kidney function, in case the dye needs to be used.
What Is A Fetal MRI?
Sometimes, when an ultrasound of a fetus indicates a problem, a fetal MRI may be performed to get a clearer picture. Since there is no radiation or contrast dye involved, its considered safe as a prenatal ultrasound that reveals a possible problem with a fetus.
What Are The Common Symptoms Of Neurological Diseases?
Since the nervous system controls all the parts of the body, neurological disorders can cause many symptoms that affect many different parts of the body. Sometimes the symptoms can even be emotional. The most common symptoms are-
- Headaches
- Lack of coordination or clumsiness, balance problems
- Being less alert
- Having difficulty reading, writing, speaking or understanding conversation
- Behavioural changes
- Numbness, weakness or loss of sensation
- Seizures.
- Complete or partial paralysis
- Pain that cannot be explained otherwise