A Neurologist in Nagpur is a medical doctor with specialized training in diagnosing, treating, and managing disorders of the brain and nervous system including, but not limited to, Alzheimer’s disease, amyotrophic lateral sclerosis (ALS), concussion, epilepsy, migraine, multiple sclerosis, Parkinson’s disease, and stroke.
A child or pediatric, neurologist specializes in the diagnosis and treatment of neurologic disorders in children from the neonatal period through adolescence. Some of the conditions overlap with those seen by adult neurologists, and others are unique to this younger population. Child neurologists treat many of the same common conditions found in adults such as migraine, epilepsy, stroke, and Tourette’s and are also trained in conditions related to neurogenetics and developmental problems.
WHAT DOES A NEUROLOGIST DO?
Diagnose
Neurologists are highly trained clinicians capable of diagnosing complex conditions through detailed history and physical examination, including testing of mental status, vision, speech, strength, sensation, coordination, reflexes, and gait. Even as medicine becomes more dependent on technology, the neurological exam will remain a critical component of the patient evaluation.
Performs Tests
Some common neurologic tests used to complete the evaluation include:
- Computed tomography (CT) or computer-assisted tomography (CAT) scans
- Magnetic resonance imaging (MRI)
- Electroencephalography (EEG)
- Nerve conduction studies and electromyography (NCS/EMG)
- Lumbar puncture (LP) for cerebral spinal fluid analysis
Performs Procedures
We are different from Neurologist in Nagpur as we do not perform brain or spinal cord surgery. However, Neurologist in Nagpur and neurosurgeons work closely together for several conditions, sometimes even in the operating room together.
General Neurologist in Nagpur perform various procedures including LP and NCS/EMG. Subspecialty-trained neurologists also perform intraoperative brain and spine monitoring, autonomic testing, endovascular procedures including angiograms and coiling of aneurysms, botulinum toxin injections, skin and muscle biopsies.
Typical neurological diseases
Training to become a Neurologist in Nagpur takes six years and is concluded with the completion of a three-part specialist examination. Afterwards, the person may then opt to specialize even further. Typical neurological diseases include:
- Stroke and cerebral hemorrhages
- Multiple sclerosis
- Parkinson’s disease
- Epilepsy
- Impaired consciousness and memory disorders, dementia
- Headaches and migraines
- Vertigo
- Sleep disorders
- Diseases of the nerves and nerve roots, such as carpal tunnel syndrome and intervertebral disk problems
- Polyneuropathy
- Restless leg syndrome
- Back pain
What are the signs that I should see a neurologist?
Discomfort in individual sections of the body, paresis, standing/gait instability, lapses in consciousness or unusual headaches are all reasons to be examined by a neurologist. A Neurologist in Nagpur should also be consulted if a person is experiencing migraines, back pain or other chronic pain. It should be noted that individuals may experience or perceive very different symptoms.
Dizzy spells, changes in hearing and speech, vision loss – neurological symptoms can affect all of the body’s sensory organs. Trembling, muscle stiffness, muscle weakness and back pain radiating into the legs and arms should be examined.
The onset of dementia can manifest itself in the form of confusion, increasing forgetfulness, loss of one’s everyday capabilities and behavioral changes. In the early stages, the patient experiences short-term memory problems and disorientation. Sufferers often have a tendency to withdraw to hide the weakness.
What is the role of the Neurologist in Nagpur?
The patient’s symptoms are discussed in detail (documenting their medical history) for the purposes of an overall evaluation. During a head-to-toe clinical neurological examination, the Neurologist in Nagpur looks for external symptoms and tests nerve reflexes, paying attention to the person’s gait and posture to determine whether there is a disorder affecting the person’s ability to balance. The examination also helps identify changes in the skin and muscles, as well as injuries (falls).
Humans have 12 cranial nerves. The functioning of these nerves may be impaired in the case of brain diseases, injuries or inflammation. Because each cranial nerve has a very specific function, they can be examined using functional tests (smell, taste, vision, sound, facial muscles…). During a neurological examination, the doctor will also regularly test the person’s mental and psychological capacities. A memory test may also be performed if there appear to be any abnormalities.
Depending on the results, additional diagnostics may be performed, including lab tests of blood and urine, or taking a sample of cerebrospinal fluid from the spinal canal (lumbar puncture).
- NCV: Measuring nerve conduction velocity
- EEG: Measuring brain waves (electroencephalography)
- EMG: Measuring muscle activity (electromyography)
- Evoked potentials: Every sensory stimulus in the body triggers brain activity that can be measured.
- Doppler and duplex sonography: Ultrasound examinations of the vessels and brain
- CT, MRI, PET: additional brain imaging methods
- Dementia testing
After carrying out the necessary examinations for the individual case, it is usually possible to diagnose one of the aforementioned neurological diseases as the cause.
If, for example, it is found that the cause is a circulatory disorder in the brain (stroke), this will also require a regular monitoring of risk factors and the cerebral vessels (ultrasound) in the course of further treatment (usually with medication).
The procedure is the same if, for example, multiple sclerosis is diagnosed as the cause of the symptoms. Once acute treatment has been started, regular clinical and follow-up checks with imaging as well as further preventative treatment are necessary.
They may have a good idea of your diagnosis from the exam, but you’ll probably need other tests to confirm it. Depending on your symptoms, these might include:
- Blood and urine tests to look for infections, toxins, or protein disorders
- Imaging tests of the brain or spine to look for tumors, brain damage, or problems with your blood vessels, bones, nerves, or disks
- A study of your brain function called an electroencephalograph, or EEG. This is done if you’re having seizures. Small patches, called electrodes, are put on your scalp, and they’re connected to a machine by wires. The machine records the electrical activity in your brain.
- A test of the communication between a nerve and the muscle it works with called an electromyogram, or EMG. This is done with electrodes on your skin or a needle put into a muscle.
- A series of tests called evoked potentials to measure your brain’s response to stimulation of your hearing, vision, and certain nerves. These are similar to an EEG, except your doctor will make sounds or flash lights to see how your brain responds.
- A small amount of fluid is taken from your spine to look for blood or infection. This is called a spinal tap or lumbar puncture.
- A muscle or nerve biopsy to look for signs of certain neuromuscular disorders. A small amount of tissue is taken and looked at under a microscope.
- A Tensilon test can help diagnose myasthenia gravis, a condition that weakens your muscles. Your doctor gives you a medicine called edrophonium (Tensilon) to see if it strengthens certain muscles and relieves your weakness temporarily.
What Makes Neurology Different
As you make your way through your clerkships, you will note that each field has a particular approach to patients, and also tends to attract a certain personality. You will find most Neurologist in Nagpur are both curious and content. Primary importance continues to be placed upon a proper history in order to arrive at the correct diagnosis and course of action. Although there are pressures upon everyone in medicine to see more patients, the initial evaluation cannot be short-rift. In clinic, a new patient visit can take an hour, and a follow-up can take 30 minutes. For a complicated new patient in the hospital with an acute problem, it may take well over an hour to do the initial assessment.
We learn medicine by talking with patients. Textbooks serve as a guide, but patients translate the medical terminology into the human experience. No one is an expert by reading a book chapter and seeing a single person with a given condition. It will take many patients with a given condition and followed over years until you begin to realize how a disease presents and affects someone. The contact with your patients is invaluable and needs to be fully appreciated. If you know how to listen and make observations, it will enrich your practice and the rest of your life.
A good history takes time. With experience, you will learn to ask open-ended and non-leading questions. Neurologist in Nagpur from a previous generation would say that you get nothing meaningful in the history during the 1st half hour! Unfortunately, there are some time constraints, so most histories should be completed in 20-30 minutes unless they are complicated.
As you obtain the history, you start to form a hypothesis about what is going on. Additional questions will further test your hypothesis and develop concepts relating to localization. You will then ask additional questions to help refine your localization. The history is a dynamic process that does require some skill and flexibility. You need to continually scrutinize the information for further clarification to help with medical decision making. You also need the know how to phrase each open-ended question so that the patient will provide a description in their own words. Computers can ask questions, physicians elicit a history. It is also crucial to understand something about the patient’s environment, and how their illness has impacted their ability to function.
The physical exam is also a dynamic process. Every patient will get a complete examination, but you need to be flexible and scientific as well. You will carefully scrutinize key parts to test your hypotheses and convince yourself whether a sign is truly present or absent. If you are unsure, you need to repeat the exam maneuver until you are sure, or look for other corroborating sign. An Attending can spend either 10 seconds on the reflexes or 5 minutes, depending upon the clinical scenario. This need to think on-your-feet becomes very enjoyable once comfortable with the concept.
In addition to talking, Neurologist in Nagpur like to examine patients. The neurological exam is very important and serves many purposes. Most patients, unless they have headaches or seizures, will have many interesting neurological findings. If you come to movement disorders or multiple sclerosis clinic, then almost everyone has an abnormal physical exam. The exam can take a substantial part of the office visit. Since you spend time touching the patient, it also helps to solidify the physician-patient relationship. The physical exam in Neurology is a most necessary element of the work-up and an inextricable component of a proper assessment.
The neuro exam will not often give you an answer as to the diagnosis, because the findings are typically not that specific. However, it will give you an idea as to where to localize, how much the person is functionally affected, and also a differential diagnosis. One can really appreciate how people have difficulties in their everyday lives by examining them.
Some may find it frustrating that most neurological diseases do not have a laboratory test that gives a ‘yes’ or ‘no’ answer. Parkinson’s disease is based solely upon the clinical characteristics of a unilateral tremor with bradykinesia, rigidity, and postural instability. Despite strides in neurodiagnostic testing, it also remains true that migraines, epilepsy, M.S., and stroke remain a diagnosis based predominantly on clinical grounds. It is not like doing a cardiac catheterization to determine if they have coronary disease. Neurologist in Nagpur know how to spend money on tests, this is for sure. However, a test without the proper reasoning will often create more confusion than illumination.
Finally, neurologists tend to enjoy talking about their specialty. Since the brain is so interesting, it is hard not to teach and discuss. Patient rounds can be long, but hopefully you will find them both educational and enjoyable. Rounds are your opportunity to observe the experienced attending, who has been doing this for some years. Everything the attending says and does with the patient is for a particular reason. There is a lot of learning that can be accomplished on rounds, even though it may not seem like there is specific