Neurologist

What is a neurologist?

A neurologist is a medical doctor who diagnoses, treats and manages disorders of the brain and nervous system (brain, spinal cord and nerves). A neurologist knows the anatomy, function and conditions that affect your nerves and nervous system. Your nervous system is your body’s command center. It controls everything you think, feel and do — from moving your arm to the beating of your heart.

What is a pediatric neurologist?

A pediatric neurologist is a medical doctor who diagnoses, treats and manages disorders of the brain and nervous system in children — from newborn to adolescent. Many of the conditions they treat are the same as those seen in adults, in addition to inherited and developmental conditions.

What is a neurosurgeon?

A neurosurgeon is a medical doctor who performs surgery on the brain, spinal cord and nerves.

What diseases and conditions does a neurologist treat?

Some of the most common neurologic disorders a neurologist may treat include:

• Alzheimer’s disease and other dementias.
• Amyotrophic lateral sclerosis (also called ALS or Lou Gehrig’s disease).
• Brain injury, spinal cord injury or vascular malformations.
• Cerebral aneurysms and arteriovenous malformations.
• Cerebral palsy and spasticity.
• Concussion.
• Encephalitis.
• Epilepsy.
• Facial pain syndromes.
• Headache/migraine.
• Hydrocephalus.
• Meningitis.
• Mental and behavioral health disorders.
• Multiple sclerosis.
• Myasthenia gravis and myopathies.
• Pain in your neck, back and spine.
• Parkinson’s disease.
• Peripheral neuropathy.
• Sleep disorders.
• Stroke.
• Tremor, dystonia.
• Tumors of the brain, spine and nerves.

How do neurologists diagnose conditions?

Your neurologist will ask about your medical history, family history, medication history and any current symptoms. They’ll also conduct a neurologic examination, including tests of your:

• Coordination, balance, reflexes and gait.
• Muscle strength.
• Mental health.
• Vision, hearing and speech.
• Sensation.

Your neurologist may also order blood, urine or other fluid tests in order to help understand condition severity or check on medication levels. Genetic testing may be ordered to identify inherited disorders. Imaging studies of your nervous system might also be ordered to aid in diagnosis.

Neurologists treat people with medications, physical therapy or other approaches.

What types of tests does a neurologist order?

Common neurologic tests include:

• Angiography. Angiography can show if blood vessels in your brain, head or neck are blocked, damaged or abnormal. It can detect such things as aneurysms and blood clots.
• Biopsy. A biopsy is the removal of a piece of tissue from your body. Biopsies may be taken of muscle, nerve or brain tissue.
• Cerebrospinal fluid analysis. This test involves the removal of a sample of the fluid that surrounds your brain and spinal cord. The test can detect evidence of a brain bleed, infection, multiple sclerosis and metabolic diseases.
• Computed tomography (CT), magnetic resonance imaging (MRI), X-raysandultrasound.
• Electroencephalography (EEG). This test measures your brain’s electrical activity and is used to help diagnose seizures and infections (such as encephalitis) brain injury and tumors.
• Electromyography (EMG). This test records the electrical activity in muscles and is used to diagnose nerve and muscle disorders, spinal nerve root compression and motor neuron disorders such as amyotrophic lateral sclerosis.
• Electronystagmography (ENG). This group of tests is used to diagnose involuntary eye movement, dizziness and balance disorders.
• Evoked potentials. This test measures how quickly and completely electrical signals reach your brain from your eyes, ears or touch to your skin. The test can help diagnose multiple sclerosis, acoustic neuroma and spinal cord injury.
• Myelography. This test helps diagnose spinal and spinal cord tumors and herniated disks and fractures.
• Polysomnogram. This test measures brain and body activity during sleep and helps diagnose sleep disorders.
• Positron emission tomography (PET). This imaging test can show tumors or be used to evaluate epilepsy, brain tumors, dementia and Alzheimer’s disease.
• Single-photon emission computed tomography (SPECT). This imaging test can diagnose tumors, infections and assess the location of seizures, degenerative spine disease and stress fractures.
• Thermography. This test measures temperature changes within your body or specific organs and is used to evaluate pain syndromes, peripheral nerve disorders and nerve root compression.

When should I make an appointment with a neurologist?

Some of the more common symptoms for which you may want to see a neurologist (or be referred to one) include:

• Memory disturbances, forgetfulness.
• Loss of consciousness.
• Seizures.
• Taste or smell disturbances.
• Vision problems.
• Numbness and tingling sensations.
• Facial asymmetries (one side of your face doesn’t match the other [eyelid droops, can’t fully smile]).
• Vertigo, ringing in the ears (tinnitus) and deafness.
• Difficulty swallowing, hoarseness in voice, difficulty in shrugging your shoulders or turning your neck, difficulty with tongue movements.
• Muscle weakness, cramps, spasms and twitching.
• Burning or electrical shock-like pain in any body part.
• Neck or back pain, headache.
• Imbalance in gait.
• Tremors.
• Slowness in movement.

How should I prepare for my first neurologist appointment?

To get the most out of your neurologist visit, it’s helpful to be prepared. Ways to prepare include:

• Bring a list of the most important issues you want to discuss with your neurologist.
• Discuss any changes in your overall health.
• Discuss your new symptoms or changes in existing or prior symptoms. Keep a symptom diary (and bring it with you) and record events, including day and time they occurred, how long the event lasted, severity, triggers, symptoms and any action you took to end the event. This is especially useful if you have a condition in which symptoms aren’t constant, such as epilepsy, sleep apnea, headaches or Parkinson’s disease.
• Bring copies of test results, including a CD of images and lab work ordered by other healthcare providers outside of your neurologist’s health care network.
• Bring a list of all current products you take. Include prescription medications, over-the-counter medications and any vitamins, supplements and herbal products. Also, let your neurologist know about any previous medications that didn’t work or that caused side effects.
• Bring a list of your known allergies.
• Bring a friend or relative with you to the appointment to take notes and be another set of ears and eyes. This person can help review your neurologist’s discussion, ask questions and remind you about scheduling tests and follow-up appointments.
• Ask if you should schedule another appointment to discuss any additional concerns.

How much schooling does it take to become a neurologist?

To become a neurologist, doctors must complete:

• Four years of college.
• Four years of medical school.
• One year of an internship (training in neurology and other fields).
• Three years of residency (continued training concentrating on the field of neurology).
• Up to three years of a fellowship. This isn’t mandatory, but a fellowship offers additional training in a neurology subspecialty. This training time may be longer if the neurologist chooses to pursue multiple fellowships.

What are some neurology subspecialty fields?

Some neurology subspecialty fields include:

• Brain injury medicine.
• Child neurology.
• Clinical neurophysiology.
• Epilepsy.
• Headache medicine.
• Geriatric neurology.
• Neurodevelopmental disabilities.
• Neuroimaging.
• Neuro-oncology.
• Pain medicine.
• Sleep medicine.
• Vascular neurology.

A note from Cleveland Clinic

A neurologist is a medical doctor who specializes in diseases and conditions affecting your brain, spinal cord and nerves. Your neurologist will examine you, order tests, make a diagnosis, treat your condition with medication or physical therapy or refer you to and work together with other specialists, such as a neurosurgeon or neuro-oncologist, if appropriate. Come prepared with your notes, share your health information and never hesitate to ask questions. Your neurologist is here to help diagnose your condition, treat or manage it as best as possible and support you along the way.