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Neurologists are doctors who diagnose and treat problems with the brain and nervous system. They don’t do surgery. Your doctor might recommend that you see one if they think you have an illness that needs expert care.
A neurologist has at least a college degree and 4 years of medical school plus a 1 year internship and 3 years of special training in neurology. Many also spend extra time learning about a specific field, like movement disorders or pain management.
A neurologist treats diseases and conditions of the brain and nervous system, but they do not perform surgery. Some of the common conditions they treat include headaches, Alzheimer’s disease, multiple sclerosis, sleep disorders, pain, brain tumors, peripheral nerve disorders, and amyotrophic lateral sclerosis (ALS). Some neurologists focus on a subspecialty like neurophysiology, pediatric neurology, epilepsy, vascular neurology, behavioral neurology, or others.
Education to Become a Neurologist in the United States
- Four years of pre-medical education in a college or university
- Four years of medical school resulting in an M.D. or D.O. degree (doctor of medicine or doctor of osteopathy degree)
- One year internship in either internal medicine or medicine/surgery
- At least 3 years of specialty training in an accredited neurology residency program
Many neurologists also have additional training or interest in one area of neurology, such as stroke, epilepsy, neuromuscular, sleep medicine, pain management, or movement disorders.
What Does a Neurologist Do?
Neurologists diagnose the underlying cause of neurological disorders, prescribe medication, order diagnostic tests, conduct physical exams, perform in office procedures and create strategies to treat neurological conditions. They take care of patients of all ages and work in medical facilities including hospitals and outpatient clinics.
An initial Neurological exam closely examines a person’s nervous system and mental status paying special attention to the nerves and brain. Some common in office procedures utilize simple testing tools such as a reflex hammer and a pen light. In addition, a detailed medical history will be taken including an evaluation of:
- Motor Skills
- Visual acuity and extraocular muscles
Based upon the outcome of these in office evaluations, a Neurologist may then order additional tests and procedures such as:
- Blood and urine tests
- Imaging of the brain or spine with MRI or CT scans
- EEG (electroencephalograph) for evaluating brain function
- EMG (electromyography) to evaluate nerve and muscle communication
- Tensilon test to evaluate Myasthenia Gravis disorders
What conditions does a neurologist treat?
Neurologists treat conditions that affect your nervous symptom. This can include injuries to your brain or spinal cord, acute conditions such as strokes, or chronic conditions such as epilepsy.
Not all head injuries will require a neurologist appointment, but sometimes a neurologist might be needed to help determine the extent of your injuries and help develop a treatment plan.
For example, people who’ve had a concussion can have symptoms that linger for months. This is called post-concussion syndrome. They might need additional testing and treatment for the headaches and memory problems the condition can cause.
Headaches are something we all experience. We can feel them stretching into our sinuses, across the top of our head, down through the muscles of the head, neck, and shoulders or along the base of the skull and brain. They can be caused by many conditions from a sinus infection to a throbbing toothache from a visit to the dentist.
Symptoms of more serious headaches, including migraines, may be vomiting, a headache that becomes more severe or is continuous, a headache that comes on suddenly or pain that is worsened by strain, a headache that starts early in the morning, changes in vision, or even seizures.
If your headache symptoms are severe enough, your primary care doctor may refer you to a neurologist.
Migraine attacks are a common reason to see a neurologist. Besides being painful, the condition often causes sensitivity to light and sound, nausea, and dizziness. The pain of a migraine can last for hours or days.
A neurologist can diagnose your migraine as well as identify any triggers you might have and recommend how to avoid them. They can also prescribe medications to prevent and treat migraine.
Numbness or tingling
Numbness or tingling can happen for many different reasons, some as simple as sitting in a way that cuts off your blood circulation or having not eaten. However, if this numbness continues, comes on suddenly, or only happens on one side of the body, it may be time to see a neurologist.
Numbness or tingling symptoms like those described can also be signs of a stroke, in which case you need to get help very quickly. While your primary care doctor can help you evaluate these symptoms, if you think you are having a stroke, get immediate medical help.
Feelings of weakness that you should see a doctor for are different than tiredness or muscle aches after a long hike or lifting too many weights. You should consult your provider if you experience muscle weakness that impacts your daily activities or a rapid decline in muscle strength, especially in your arms and legs. It could be caused by a more serious condition or disease of your nervous system, such as stroke.
Seizure or epilepsy
A seizure causes uncontrolled movements and strange sensations. In many cases, it also causes the person having it to lose consciousness. Seizures start in your brain and can be dangerous.
After you’ve had a seizure, a doctor might refer you to a neurologist for further testing. They can do tests and imaging to find the cause of your seizure. They can also diagnose long-term seizure conditions, such as epilepsy.
Once you have a diagnosis, a neurologist can prescribe medications and treatments to help control your seizures.
A stroke occurs when you lose blood supply to your brain. Without blood supply, brain cells begin to die. This can cause difficulty with speech, controlling your emotions, and more. Even when the stroke is over, you’ll need treatment to regain any skills that were lost.
A neurologist can help assess the extent of the damage to your brain. They can develop a treatment plan and prescribe medications to help you recover.
While we know many obvious causes of sleep problems, going to bed too late, having a condition like sleep apnea or anxiety, nightmares, or others, some sleep problems are neurological disorders. An example of this is narcolepsy, which is a chronic, genetic disorder with no known cause that affects the body’s central nervous system.
Many of these symptoms could be part of a disorder that is not neurological. Your primary care doctor is your greatest resource in helping you decide if you should see a neurologist. However, if your symptoms are severe enough or you are still not confident in your primary care doctor’s recommendations, you may need to make an appointment with a neurologist.
How to find a neurologist?
Ask your doctor to refer you to a neurologist who has a special interest in your condition or disorder. You can also use healthdirect’s online service finder.
You may be referred to a hospital neurology unit, such as a stroke centre, or to an outpatient clinic or program catering for a particular neurological condition, such as epilepsy or motor neurone disease.
It can take months to get an appointment with a neurologist. However, if your doctor finds you have a serious illness or need urgent treatment, you should be able to get an earlier appointment.
A neurologist can use electromyography (EMG) to assess how well a person’s muscles respond to electrical stimulation from motor neurons, which are specialized nerves that control muscle movement.
During an EMG, a specially trained technician inserts small needles called electrodes into the muscle. These electrodes record the different electrical activity that occurs in muscle tissue during periods of movement and rest.
The EMG machine produces an electromyogram, which is a record of this activity.
Neurologists can use the results of an EMG to diagnose neuromuscular diseases, such as myasthenia gravis and ALS.
Neurologists use electroencephalograms (EEG) to measure and record electrical activity in the brain. Neurons in the brain communicate with other neurons through electrical impulses, which an EEG can pick up. An EEG can also track brain wave patterns.
During an EEG, a technician will place electrodes on the person’s head. These electrodes connect to a computer that converts electrical signals into patterns that the technician can view on a screen or print on a piece of paper.
Neurologists can use EEG results to identify abnormal electrical activity in the brain and diagnose certain conditions, such as:
- brain tumors
- sleeping problems