Definition and Overview
Neurology is a specialised field of medicine that deals with the diagnosis, treatment and management of disorders that affect the nervous system. This system has a complex network of nerves, blood vessels, tissues and muscles, which make up the different nervous subsystems, including the central, peripheral, autonomic and somatic nervous systems.
The patient will not encounter a neurologist as a primary healthcare provider. A family doctor or general physician typically refers a patient to a neurologist when signs and symptoms of a neurological disorder have been observed.
After the initial consultation with a neurologist, the patient must return to his or her primary healthcare provider to discuss the findings. A follow-up consultation with the neurologist can be scheduled to monitor the progress of the disease or treatment, or to determine if additional intervention should be prescribed to help the patient manage the condition.
Who Should Undergo and Expected Results
Patients referred for an initial consultation with a neurologist should check with their primary care physician if a follow-up visit is necessary. There is a wide list of neurological disorders and conditions that warrant a follow-up neurology consultation, including the following:
- Alien hand syndrome
- Asperger syndrome
- Attention deficit hyperactivity disorder (ADHD)
- Auditory processing disorder
- Amyotrophic lateral syndrome (ALS)
- Autism spectrum
- Bipolar disorder
- Bell’s palsy
- Brain damage and injury
- Brain tumor
- Carpal tunnel syndrome
- Cephalic disorder
- Cerebral arteriosclerosis
- Cerebral atrophy
- Cerebral palsy
- Chronic fatigue syndrome
- Complex regional face syndrome
- Cranial arteritis
- Cytomegalic inclusion body disease (CIBD)
- Cumulative trauma disorders
- Diabetic neuropathy
- Diffuse sclerosis
- Down syndrome
- Erb’s palsy
- Essential tremor
- Familial spastic paralysis
- Febrile seizures
- Foetal alcohol syndrome
- Generalized anxiety disorder
- Head injury
- Inflammatory myopathy
- Learning disabilities
- Lumbar disc disease
- Lyme disease
- Mini-stroke or transient ischemic attack
- Motor skills disorder
- Multiple sclerosis
- Muscular dystrophy
- Neurological manifestations of diseases such as AIDS and lupus
- Nonverbal learning disorder
- Parkinson’s disease
- Phantom limb or pain
- Pinched nerves
- Pituitary tumors
- Polio and post-polio syndrome
- Prion disease
- Primary lateral sclerosis
- Repetitive stress injury
- Restless legs syndrome
- Sensory processing disorder
- Sleep apnea
- Sleeping sickness
- Spinal cord injury
- Spinal cord tumors
- Spinal muscular atrophy
The primary care physician will always refer the patient to an initial or follow-up consultation with a neurologist should it be necessary for the development of an effective and efficient treatment plan.
How is the Procedure Performed?
During a follow-up consultation, the neurologist will review the patient’s health history, especially if several weeks or months have gone by since the initial consultation. This will cover the problems, signs, or symptoms that are currently plaguing the patient, as well as recent hospital confinement or surgical treatment. The neurologist will also ask about recently taken medication for other conditions.
The interview is typically followed by a neurological examination. The tests will vary depending on the main complaint, as well as the history of disorder, treatment, and management, but will include at least one of the following:
- Motor examination - This involves checking the strength and mobility of the patient’s muscles. This test can also check the muscular reflexes of the patient.
- Sensory examination – As the name suggests, this test involves checking the patient’s senses. The doctor can test the patient’s sense of touch by using vibration, among others.
- Mental examination – This determines if a patient with memory problems has progressed since the last consultation, or if his memory has been affected by the patient’s neurological disorder.
- Cranial examination – This involves checking the movements of the eyes and facial muscles
- Cerebellar testing – This checks the patient’s muscular and motor coordination
After the neurological exam, the doctor can order diagnostic tests or imaging procedures to monitor the patient’s response to the treatment or the progress of the disorder. With a follow-up consultation, the neurologist can confirm an earlier diagnosis or simply monitor the patient’s condition and help the primary healthcare provider in developing a better treatment plan. Diagnostic tests include x-ray, computerized tomography (CT) scans, magnetic resonance imaging (MRI), carotid ultrasound, Doppler ultrasound and myelograms.
Possible Risks and Complications
Neurology follow-up consultations are generally safe and do not pose risks to the patient particularly if there are no procedures involved.
- The Neurology Center
- National Institute of Neurological Disorders and Stroke
- National Health Services
- American Academy of Neurology