Neurologists are medical professionals who specialize in diagnosing and treating conditions that affect the nervous system.
A general practice doctor might make a referral to a neurologist if they believe that an individual shows signs of a neurological problem. Neurological issues encompass a broad range of conditions, including Alzheimer’s disease, diabetic neuropathy, headache, and nerve damage.
In this article, we discuss what neurologists do, including the types of conditions that they treat, the procedures they perform, and when a person might see this specialist.
What is a neurologist?
A doctor may refer a person with neurological problems to a neurologist.
A neurologist is a medical doctor who specializes in evaluating, diagnosing, and treating diseases that affect the nervous system.
The nervous system has two parts:
- the central nervous system (CNS), which refers to the brain and spinal cord
- the peripheral nervous system (PNS), which includes all of the nerves outside of the CNS
Due to the complex nature of the nervous system, many neurologists focus on treating certain populations of people or people with specific neurological diseases.
After completing their residency training, many neurologists spend a year or more in a fellowship program where they gain experience in their subspecialty.
Examples of subspecialties within the field of neurology include:
- pediatric or child neurology
- neurodevelopmental disabilities
- neuromuscular medicine
- hospice and palliative care neurology
- pain medicine
- headache medicine
- sleep medicine
- vascular neurology
- autonomic disorders
- neuropsychiatry
- brain injury medicine
- neurocritical care
- epilepsy
What conditions do they treat?
Neurologists treat neurological conditions, which are problems that affect the brain, spinal cord, and nerves. These conditions include:
- stroke
- epilepsy
- headaches and migraines
- brain tumors
- brain aneurysms
- peripheral neuropathy
- sleep disorders
- neurodegenerative diseases, such as Parkinson’s disease and Alzheimer’s disease
- neuromuscular diseases, such as myasthenia gravis, multiple sclerosis (MS), and amyotrophic lateral sclerosis (ALS)
- infections of the nervous system, such as encephalitis, meningitis, and HIV
What procedures do they do?
Neurologists perform a range of different tests and procedures to diagnose and treat neurological conditions.
Some of these procedures include:
Lumbar puncture
A neurologist can use a lumbar puncture to collect a sample of spinal fluid. They may use this procedure to help diagnose the following conditions:
- meningitis
- encephalitis
- myelitis
- leukemia
- autoimmune diseases, such as multiple sclerosis (MS)
- dementia
- bleeding in the brain
Neurologists can also use a lumbar puncture to treat conditions that affect the spinal cord. They can inject anesthetics, antibiotics, or cancer treatments using a lumbar puncture needle.
Electromyography
An EMG is one procedure a neurologist may perform.
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.
Electroencephalogram
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:
- epilepsy
- seizures
- brain tumors
- sleeping problems
Tensilon test
Myasthenia gravis is a rare neuromuscular disease that weakens the muscles in the arms and legs. A neurologist can use a blood test called a Tensilon test to diagnose myasthenia gravis.
Tensilon is the brand name of a drug called edrophonium, which prevents the breakdown of acetylcholine, a neurotransmitter that stimulates muscle movement. Myasthenia gravis causes the immune system to attack acetylcholine receptors in the muscles, which causes muscle fatigue and decreased muscle movement.
During a Tensilon test, a neurologist will inject a small amount of Tensilon into the bloodstream. Then, they will ask the person to perform different movements, such as:
- standing up and sitting down
- holding their arms above their head
- crossing and uncrossing their legs
The neurologist will continue administering doses of Tensilon each time the person feels tired. If the person notices that their strength returns after each Tensilon injection, this indicates that they are likely to have myasthenia gravis.
Other tests
A neurologist can use the following tests to help diagnose neurological disorders:
- laboratory tests, such as blood and urine analyses
- imaging tests, such as ultrasounds and MRI, CT, and PET scans
- genetic testing
- biopsy
- angiography
When to see a neurologist
A primary care doctor might refer someone to a neurologist if they have symptoms that indicate a neurological condition, such as:
- frequent or severe headaches
- muscle weakness
- confusion
- dizziness
- loss of coordination
- partial or complete paralysis
- sensory changes that affect the sense of touch, vision, smell, or taste
Neurologists vs. neurosurgeons
Neurosurgeons perform surgery that relates to the nervous system.
Both neurologists and neurosurgeons treat people who have conditions that affect the nervous system. However, neurosurgeons perform surgery, whereas neurologists do not.
Neurosurgeons go through medical school and receive specialist training in neurology. They also complete a residency in neurosurgery, during which they observe and participate in surgical procedures on the brain and spinal cord.
Generally, a person will first meet with a neurologist, who will evaluate their symptoms and decide on a treatment plan. If a neurologist believes that the person requires surgery, they will refer them to a neurosurgeon.
Summary
Neurologists diagnose and treat medical conditions that affect the nervous system.
A person might see a neurologist if their general practice doctor refers them to one of these specialists. This referral can happen if a person shows signs of a neurological disorder, such as:
- persistent or severe headaches
- muscle weakness
- confusion
- dizziness
- loss of coordination
- partial or complete paralysis
Neurologists can perform various procedures to help them diagnose and treat neurological conditions. However, if a person requires surgery, their neurologist or primary care doctor will refer them to a neurosurgeon.
