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Neurology
Overview
Neurology deals with the evaluation, diagnosis, and management of disorders of the brain, spinal cord, peripheral nerves, neuromuscular junction and muscles. As a healthcare provider dedicated to providing the finest possible care, the Department of Neurology at Max Hospitals provide comprehensive diagnostic and therapeutic Neurology services as per internationally accepted evidence-based protocols.
Along with chronic neurological cases and regular OPDs, the Max Neurology Department is also adept at handling emergencies such as Convulsions, Stroke, head trauma, change in mental status/coma, intracranial haemorrhage, myasthenic crisis and infections.
The competence of the department is further supported by well-equipped Neuro ICU facilities, Bi-plane cath labs and bedside Electro Encephalogram (EEG) Monitoring for managing patients with neurological illnesses. A team of highly skilled and experienced specialists that is available round the clock and state-of-the-art imaging modalities such as 3T MRI and CT scan give the Department of Neurology the advantage of providing the best in patient care.
Neurologists treat the following disorders:
Headaches: All types of primary headaches, especially migraine and secondary headaches.
Stroke: Considered a brain attack due to either occlusion or blockage of blood supply of the brain or due to rupture of brain vessels. A stroke is a medical emergency.
How to identify stroke:
- Acute onset weakness of the face, arm, or leg.
- Acute onset dizziness, imbalance, double vision, difficulty in swallowing or slurring of speech
- Acute onset loss of voice or not able to understand or amnesia
U CAN REMEMBER IT AS: BE-FAST
B: Balance
E: Eye signs (like blurring or loss of vision or diplopia)
F: Facial weakness
A: Arm weakness
S: Speech slurring
T: Time to call
What to do:
Keep patient in left lateral position and shift immediately to the hospital where facilities of stroke treatment are available (Thrombolysis plus mechanical thrombectomy).
Seizure or epilepsy: An epileptic seizure was defined by the International League Against Epilepsy (ILAE) as "a transient occurrence of signs and/or symptoms due to abnormal excessive or synchronous neuronal activity in the brain. Epilepsy is defined as any of the following:
- At least two unprovoked or reflex seizures occur more than 24 hours apart.
- One unprovoked or reflex seizure and chances of seizures in future that are similar to the general risk of at least 60% after two unprovoked seizures occurring over the next ten years.
- Diagnosis of the epilepsy syndrome.
What to do if someone around you has a seizure:
- Remove all sharp objects
- Keep patient in left lateral position
- Don't put anything inside your mouth
- Shift the patient to the hospital
Important instructions for patients:
- Driving and swimming are not allowed
- Don't miss the dose
- If you missed one dose, then take two tablet stat and follow the previous prescription
Parkinson's disease and other hypokinetic disorders: It is a progressive degenerative disorder affecting the brain in which the most important symptoms are the slowness of activities of daily living, tremors of the hand, bradykinesia and freezing episodes and falls. Medications can help to manage the symptoms of Parkinson's disease. Usually, dopamine-increasing medications are given to patients. Deep brain stimulation is also a better option if the patient fulfils the prerequisite criteria for DBS.
Meningitis and Encephalitis: Due to inflammation of the meninges and brain. It could be due to viral, tubercular, bacterial or fungal. The patient usually presents with a history of fever, headache, vomiting, neck pain and drowsiness. Encephalitis mainly occurs due to viral infection or autoimmune process in which the patient usually presents with fever, headache, seizures, psychosis etc. Early diagnosis and treatment are mandatory because it is a curable disease.
Demyelinating disorders (Multiple sclerosis, NMOSD etc.): These are immune-mediated disorders in which demyelinating lesions in the brain and spinal cord will occur. Patients usually present with unilateral or bilateral loss of vision, fatigability, gait ataxia, recurrent hiccups and difficulty walking. Early and appropriate treatment is required because once it reaches a degenerative condition, complete recovery will not be possible. Apart from medical management, rehabilitation and physiotherapy play a great role in management.
Cognitive disorders: There are reversible and irreversible types of dementia. The reversible cause of dementia needs to be ruled out. Dementia is broadly classified into cortical and subcortical dementia. Alzheimer's disease is known to be the most common cause of cortical dementia. The most challenging and appropriate evaluation is required in cases of rapidly progressive dementia.
When do you need to see a neurologist?
Patients may need to see a neurologist if they:
- Have suffered from seizures.
- Are facing specific taste and smell disturbances.
- Have suddenly become forgetful and frequently forget events that occurred in the near past.
- Feel a sensation of Numbness and tingling, especially in the patient's legs and arms.
- Facing vision problems like blurred vision, double vision, etc.
- Suffer from vertigo.
- Have suddenly faced deafness.
- Are witnessing slowness in movement.
- Are constantly experiencing tremors.
- Are facing muscle weakness, spasms, twitching, and cramps.
- Have an electric shock-like pain in the body.
- Find Swallowing food challenging.
- Have noticed sudden hoarseness in the patient's voice.
- Is finding it difficult to shrug his shoulder or move his neck.
- Is finding tongue movements challenging.
- There is an imbalance in gait.
- There are noticeable facial asymmetries.
Diagnosis
Neurologists may order several diagnostic tests to detect the cause and measure the extent of the disease and disorder. Some of the diagnostic tests conducted by them are:
- Biopsy: A small part of brain tissue is extracted and studied under a microscope. Biopsies help to determine if the tumours are cancerous or benign.
- Electroencephalography: This test is conducted to measure the brain's electrical activity. It is vital in diagnosing seizure focus.
- Angiography: Angiography provides a better view of the patient's blood vessels to the doctor. It is conducted to detect blood clots and aneurysms.
- Electromyography: It records the electrical activity in the patient's muscles. It is usually performed to diagnose muscle and nerve disorders.
- Polysomnogram: This test helps measure body and brain activity during sleep. It is crucial to diagnose sleeping disorders.
- Evoked potential Test: This test helps measure the speed at which electrical signals from the patient's brain reach his ears, skin, or eyes. It also measures how completely these electrical signals pass. It can help to diagnose conditions like spinal cord injury, acoustic neuroma, etc.
- Thermography: This test measures the temperature changes within the patient's body. Thermography is usually ordered to evaluate peripheral nerve disorders, pain syndrome, and nerve root compression.
- Cerebrospinal fluid analysis: Here, a sample of the fluid surrounding the patient's brain is extracted and studied. Cerebral spinal fluid analysis can help to detect infection, metabolic diseases, multiple sclerosis, and brain bleeding.
- Imaging: A neurologist may order imaging tests like CT scans, MRI scans, and ultrasounds to get a better picture of the abnormal mass growth in the patient's brain. This helps the doctors to determine the extent of progression made by the tumours in the brain.
- Positron emission Tomography: This imaging scan helps doctors to get a clearer view of the tumours or metastasis. It also helps to evaluate diseases like Alzheimer's' and epilepsy.
The results of the tests mentioned above will be available within 24 hours. Medicines and treatments will be prescribed according to the results of these tests. Consult a doctor immediately if you think you may suffer from a neurological condition.
Review
Reviewed by Dr. (Col) Joy Dev Mukherji, Principal Director and Head - Neurology on 04-Jan-2023.
Neurology explained
Neurology explained
Dr. (Col) Joy Dev Mukherji, Principal Director and Head - Neurology
Our Medical Experts
Max Healthcare is home to 5000 eminent doctors in the world, most of whom are pioneers in their respective fields. Additionally, they are renowned for developing innovative and revolutionary clinical procedures.
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