A neurologist is a medical doctor who specializes in treating diseases of the nervous system. The nervous system is made of two parts: the central and peripheral nervous system. It includes the brain and spinal cord.
Illnesses, disorders, and injuries that involve the nervous system often require a neurologist’s management and treatment.
Before they can practice, neurologists must:
- graduate from medical school
- complete an internship
- receive three years of training in a Neurology residency program
Neurologists manage and treat neurological conditions, or problems with the nervous system. Symptoms that commonly require a neurologist include:
- coordination problems
- muscle weakness
- a change in sensation
People who are having problems with their senses, such as touch, vision, or smell, may also need to see a neurologist. Problems with senses are sometimes caused by nervous system disorders.
Neurologists also see patients with:
- seizure disorders, such as epilepsy
- multiple sclerosis
- neuromuscular disorders, such as myasthenia gravis
- infections of the nervous system, including encephalitis, meningitis, or brain abscesses
- neurodegenerative disorders, such as Lou Gehrig’s disease and Alzheimer’s disease
- spinal cord disorders, including inflammatory and autoimmune disorders
- headaches, such as cluster headaches and migraines
Because the nervous system is complex, a neurologist may specialize in a specific area. They will do a fellowship in that area after residency training. Subspecialties have evolved to narrow a doctor’s focus.
There are many subspecialties. Some examples of subspecialties include:
- headache medicine
- neuromuscular medicine
- neurocritical care
- geriatric neurology
- autonomic disorders
- vascular (stroke care)
- child neurology
- intervention neuroradiology
During your first appointment with a neurologist, they will likely perform a physical exam and a neurological exam. A neurological exam will test muscle strength, reflexes, and coordination. Since different disorders can have similar symptoms, your neurologist may need more testing to make a diagnosis.
Neurologists may recommend a variety of procedures to help diagnose or treat a condition. These procedures may include:
Your neurologist may use a lumbar puncture to test your spinal fluid. They may recommend the procedure if they believe your symptoms are caused by a problem in your nervous system that can be detected in your spinal fluid. The procedure involves inserting a needle into the spine after numbing it and taking a sample of spinal fluid.
This procedure can help your neurologist diagnose myasthenia gravis. In this test, your doctor injects you with a medicine called Tensilon. Then they observe how it affects your muscle movements.
By applying electrodes to your scalp, this test measures electrical activity in the brain.
Neurologists may use other types of tests, as well. Although they may not perform the test, they may order it, review it, and interpret the results.
To make a diagnosis, a neurologist may use imaging tests such as:
- computed tomography, or CT scan
- magnetic resonance imaging, or MRI scan
- positron emission tomography, or PET scan
Other diagnostic procedures include sleep studies and angiography. Angiography determines blockages in the blood vessels going to the brain.
Your neurologist may help you manage your symptoms and neurological disorder alone, or with your primary care physician and other specialists.