What Is a Neurologist?

Expertise and Training of Brain and Nervous System Specialists

A neurologist is a doctor with specialized training in diagnosing and treating diseases of the brain, spinal cord, peripheral nerves, and muscles. Most of the time, a primary care doctor refers patients to a neurologist if they have symptoms that indicate a neurological condition.

Neurologists are not surgeons. Those who perform surgery are called neurosurgeons and they undergo a surgical, rather than internal medicine, residency.

Neurologists receive extensive education and training, including four years of undergraduate studies, four years of medical school, three years of residency, and one to three more years in a neurology fellowship. All told, there are around 16,000 practicing neurologists in the United States.

Conditions Managed by a Neurologist
Verywell / Kelly Miller

Concentration

A neurologist will often treat patients who have these medical conditions:

Stroke

You might see a neurologist if you have difficult to manage stroke risk factors, are seen in the hospital within a few hours of having a stroke, have an unexplained stroke, have recurrent strokes, or have unusual effects of a stroke.

Neurological Trauma

Traumatic brain injury occurs when a sudden, external, physical assault damages the brain.

Tumors of the Nervous System

This includes the 130 different types of brain and central nervous system tumors, ranging from benign to malignant.

Infections of the Nervous System

These include meningitis, inflammation of the fluid that surrounds the brain and spinal cord, and encephalitis, inflammation of the brain.

Autoimmune Diseases

People who have autoimmune diseases that affect the nervous system, such as multiple sclerosis, may work with a neurologist.

Seizures and Seizure Disorders

Abnormal electrical activity in the brain can cause seizures. Epilepsy is a condition in which a person has repeated seizures. Diagnosis and treatment of these disorders often require consultation with a neurologist.

Movement Disorders

These include conditions like Parkinson's disease, as well as problems with movement, including clumsiness, tremor, rigidity, unintentional movements, or difficulty walking.

Neuromuscular Disorders

Conditions like Lou Gehrig's disease (aka amyotrophic lateral sclerosis or ALS) affect the nerves that control your voluntary muscles. 

Headaches

The two commonest types of headache in neurological practice are migraines and tension headaches.

Dementia

Dementia is an umbrella term for different types of cognitive impairment, including Alzheimer's disease.

Sleep Disorders

Narcolepsy is a type of neurological disorder.

Peripheral Neuropathy

Peripheral neuropathy refers to the many conditions that involve damage to the peripheral nervous system, the vast communication network that sends signals between the central nervous system (the brain and spinal cord) and all other parts of the body.

Procedural Expertise

Neurologists are trained and authorized to perform the following procedures:

Lumbar punctures (aka spinal taps), a procedure in which a small amount of cerebrospinal fluid, the protective fluid that surrounds your brain and spinal cord, is removed from your spinal canal so it can be studied.

Electromyography (EMG), a test that checks the health of the muscles and the nerves that control the muscles.

Tensilon test, a diagnostic test used to evaluate myasthenia gravis, a neuromuscular condition characterized by muscle weakness.

Electroencephalogram (EEG), a non-invasive test that detects abnormalities in your brain waves or in the electrical activity of your brain.

Sleep study (polysomnogram), a non-invasive, overnight exam that allows doctors to monitor you while you sleep to see what's happening in your brain and body.

Botulinum toxin injections, which are used therapeutically to control the muscle stiffness and spasticity that can occur as a result of a number of neurological disorders.

Subspecialties

Many neurologists choose to treat only certain populations of patients or specific conditions. Some examples include:

Child Neurology

A child or pediatric neurologist treats the one in six children who will have problems with their nervous system.

Hospice and Palliative Medicine

Palliative medicine is a specialty that aims to recognize, prevent, and alleviate suffering in patients with serious—often end-stage—neurological illnesses, such as Parkinson disease, dementia, amyotrophic lateral sclerosis, and brain tumors.

Neurodevelopmental Disabilities

These specialists focus on a group of disorders that begin in childhood, affect three or more areas of life function, and encompass disorders of language, movement, the special senses, and cognition.

Neuromuscular Medicine 

Specialists in this area care for patients who have diseases that affect:

• The peripheral nervous system, which is composed of nerves that are outside the brain and spinal cord

• The neuromuscular junction, which connects nerves to muscles to convey signals for muscle movement. Myasthenia gravis, a chronic, highly treatable disease, is the most common of this type of neuromuscular disorder.

• Muscles. Diseases of muscle are often classified as either muscular dystrophy or myopathy.

Pain Medicine

These specialists treat chronic pain from a host of conditions including headache, low back pain, cancer pain, arthritis pain, neurogenic pain (pain resulting from damage to the peripheral nerves or the central nervous system), and psychogenic pain (pain not due to past disease or injury or any visible sign of damage inside or outside the nervous system).

Sleep Medicine

Sleep problems may be caused by damage to part of the brain that occurs with brain injury or stroke, or other central nervous system-related diseases, such as Parkinson's disease. These specialists are well versed in sleep medicine.

Vascular Neurology

These specialists evaluate, treat, and study diseases that affect the structure and function of the blood vessels supplying the brain. They often care for patients who suffer from conditions like stroke, hence the reason they're also called "stroke doctors."

All neurologists have a great deal of experience in managing strokes. Vascular neurology requires additional subspecialty training that may take between one to three years and is focused on the latest techniques in stroke care, including interventional treatments.

Autonomic Disorders

These specialists focus on the problems associated with your autonomic nervous system, which regulates the function of the body’s internal organs, such as heart rate, blood pressure, digestion, and body temperature.

Training and Certification

After completing medical school and earning an M.D. (doctor of medicine) or D.O. (doctor of osteopathy) degree, neurologists complete a one-year internship in either internal medicine or medicine/surgery. Following that, neurologists complete at least three years of specialty training in an accredited neurology residency program, during which they learn the ins and outs of neurological medicine.

After completing residency training, neurologists are eligible to seek board certification from medical organizations, such as the American Board of Psychology and Neurology (ABPN). Prospective candidates may become certified as neurologists or child neurologists after completing a certification examination. Once certified, neurologists participate in the ABPN 10-year certification maintenance program to ensure they're constantly learning and improving in their careers.

Appointment Tips

If you have a symptom that seems to indicate a neurological problem, you may be tempted to go straight to a neurologist rather than a primary care doctor. Sometimes it can be difficult even for medical professionals to determine whether a neurologist or different doctor is best for you. Having a primary care physician helps ensure that someone is responsible for coordinating your medical care. This can prevent information from being lost and tests from being unnecessarily repeated. Coordinated medical care also reduces the likelihood of drug interactions or overdoses.

That said, if you already have a diagnosed neurological condition, are unhappy with the care your primary doctor is providing, or simply would like another opinion, then seeing a neurologist is reasonable.

To get the most out of a neurology appointment, arrive early and bring any tests, reports, or imaging studies relevant to your condition. You can also ask your primary care physician to forward these electronically in advance of your appointment.

It also helps to write down all of the medications you take, both pharmaceutical and over-the-counter, and to include any information that can aid in the diagnosis (including past hospitalizations or a family history of neurological disorders). In this way, you can get the facts straight and avoid forgetting things.

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Article Sources

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