About Neurology

A neurologist is a medical doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system. Pediatric neurologists are doctors with specialized training in children’s neurological disorders.

A neurologist’s educational background and medical training includes an undergraduate degree, four years of medical school, a one-year internship and three years of specialized training. Many neurologists also have additional training in one area of neurology such as stroke, epilepsy or movement disorders.

Neurologists are principal care providers or consultants to other physicians. When a patient has a neurological disorder that requires frequent care, a neurologist is often the principal care provider. Patients with disorders such as Parkinson’s disease, Alzheimer’s disease or multiple sclerosis may use a neurologist as their principal care physician.

In a consulting role, a neurologist will diagnose and treat a neurological disorder and then advise the primary care physician managing the patient’s overall health. For example, a neurologist would act in a consulting role for conditions such as stroke, concussion or headache.

Neurologists can recommend surgical treatment, but do not perform surgery. When treatment includes surgery, neurologists will monitor surgically treated patients and supervise their continuing treatment. Neurosurgeons are medical doctors who specialize in performing surgical treatments of the brain or nervous system.

Many disorders can be treated. Treatment or symptomatic relief is different for each condition. To find treatment options, neurologists will perform and interpret tests of the brain or nervous system. Treatment can help patients with neurological disorders maintain the best possible quality of life.

During a neurological examination, the neurologist reviews the patient’s health history with special attention to the current condition. The patient then takes a neurological exam. Typically, the exam tests vision, strength, coordination, reflexes and sensation. This information helps the neurologist determine if the problem is in the nervous system. Further tests may be needed to confirm a diagnosis or to find a specific treatment.

An examination is used when a family doctor seeks a specialized opinion about a patient whose symptoms may involve the brain or nervous system. The examination may also be performed when a patient wants a second opinion from a neurologist. The neurologist’s expertise in disorders of the brain and nervous system can give patients effective diagnosis and treatment for neurological disorders.

The American Academy of Neurology supports a patient’s choice to receive principal care services from either a neurologist or other physician. The American Academy of Neurology also supports direct access to neurologists and standing referrals for those who require frequent specialty care because of complex neurological conditions.

Advocating for patients, the American Academy of Neurology supports legislation assuring fair treatment of patients with neurological disorders and access to necessary medical care.

In recent years, research has advanced understanding of the brain’s fundamental mechanisms. With this new understanding, neurologists are finding new treatments and, ultimately, cures for many neurological diseases, which are among the most destructive and costly public health problems in the United States.

For example, research breakthroughs now allow neurologists to successfully treat stroke patients with clot-busting medication proven to reduce deaths and decrease disability. Research developments have also produced new medications that relieve migraines, slow the progression of multiple sclerosis and improve movement in Parkinson’s patients. These are just a few of the many advances gained from research that are improving the lives of millions of men and women around the world suffering from neurological disorders.

The goal of both the American Academy of Neurology and the American Academy of Neurology Education & Research Foundation is to support the best possible care for patients with neurological disorders.

The American Academy of Neurology is a nonprofit professional medical association of neurologists and allied neuroscience professionals.

The mission of the American Academy of Neurology Education & Research Foundation is to encourage research and education in the neurosciences while advancing public understanding of the disorders of the brain and nervous system.

Computerized tomography or computer assisted tomography (CT or CAT scan)
This test uses x-rays and computers to create two-dimensional pictures of selected body parts. Dye may be injected into a patient’s vein to obtain a better picture. 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. Because MRI utilizes a very strong magnet, if you have metal in your body other than dental fillings, notify your physician. Be sure to tell your physician if you suffer from claustrophobia (fear of closed areas). A physician can offer recommendations that can help you relax. This test is painless.

Transcranial Doppler (TCD)
A test that uses sound waves to look at major blood vessels in 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 waves to analyze blood flow and blockage in the blood vessels in or leading to the brain. This test is painless.

Electrical activity or response tests

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 from 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 muscles and mild electrical shocks are given to stimulate the nerve. Discomfort may be associated with this test.

Evoked potentials
This test records the brain’s electrical response to visual, auditory and sensory stimuli. This test is useful in evaluating and diagnosing symptoms of dizziness, numbness and tingling, as well as some visual disorders. Discomfort may be associated with this test.

Sleep studies
Involves tests that 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. This test is painless.

Another common test
Cerebral spinal fluid analysis
(Spinal tap or lumbar puncture)
This test is used to check for bleeding, hemorrhage, infection or other disorders 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 needed to diagnose the specific problem is removed and the needle is withdrawn. Discomfort may be associated with this test.

(This information was obtained from a pamphlet published by the American Academy of Neurology)