Neuroscience is the scientific study of the nervous system and diseases that affect it. When the nervous system is disturbed patients develop problems such as weakness, numbness, convulsions, loss of speech, memory, swallowing, vision and coordination. The nervous system is essential to almost every daily activity we undertake. Neurologists treat neurological problems through medical means (see below “What does a Neurologist Do”), while Neurosurgeons use surgical and other interventions to treat neurological disorders, which are described in the next section.
Requiring care and advice for a neurological or neurosurgical problem can be a source of worry and concern. Fortunately, medicine and science move very quickly with regard to many neurological ailments with constant improvements in technology and increasing treatment options. As a result, neurological and neurosurgical care have become increasingly sub-specialised including special training for individual physicians, nurses and technicians and the development of a team approach for different neurological problems in order to find the best approach and treatment.
We are planning specialised team-approach oriented care in the following areas:
1) Seizure and epilepsy care including diagnosis, medical treatment (usually medications), imaging (MRI and other types of scans), memory assessment, and consideration for surgical treatment for seizure control. Contrary to what most people think, the most common seizures are not big convulsions, but more subtle blank spells usually with some loss of awareness. The goal in epilepsy care is to have no seizures with no side effects of treatment. This is achievable in 2 of 3 people. In more difficult cases, we continue to strive towards this goal.
Surgical treatment for epilepsy is reserved for people who cannot be controlled with medications and who are appropriate surgical candidates. In good surgical candidates, surgery should be considered earlier and not as a last resort. Although there is agreement among most centres as to types of epilepsy that are definitely not treatable surgically and ideal surgical candidates, opinions differ greatly when it comes to possible surgical candidates that require more complex assessment. A multidisciplinary team addresses all complex issues.
(Referral by GP)
2) Brain tumour treatment including assessment, imaging, computer- guided surgical treatment, radiosurgery (computer-guided single dose radiation) and adjuvant treatment (radiation and chemotherapy). With modern imaging technology (CT, MRI, other forms of MR scans, CT-PET), we can have a pretty good idea regarding the nature of a possible brain tumour before planning any treatment. For very slow growing tumours with few symptoms, it may be reasonable not to treat and just to watch for changes on scans over months or years.
Conversely, the window of opportunity for treatment may be appropriate before more symptoms develop. For faster growing tumours, we try to find treatment options that are as beneficial as possible, while keeping risks as low as possible. There are treatments that are proven, treatments that are promising and treatments that are unproven. The field is constantly changing and we are intent that any treatments that are proven or promising should be made available at Beacon Hospital as soon as possible. The multidisciplinary team includes radiology, medical oncology, radiation oncology, nursing, psychology, neurology and neurosurgery.
(Referral by GP)
3) Multidisciplinary pain management. A collaboration between medical, neurological and anaesthesia and neurosurgery specialists is optimal for comprehensive pain management. When appropriate, procedures may include implanted stimulators (pacemaker-type) to nerves, the spine or the brain.
(Referrals via the pain management services at Beacon Hospital or other hospitals.)
4) Spine Problems. At Beacon, neurologists, pain specialists, neurosurgeons, orthopaedic surgeons and physiotherapists will be available for a comprehensive approach to spinal disorders.
5) General Neurological Consultations. (Referral by GP)
What does a Neurologist do?
A neurologist is a doctor who specializes in the diagnosis and treatment of disorders of the nervous and muscular system. The nervous system consists of the brain, spinal cord, and all the nerves in our bodies and the muscles they control.
Some of the diseases and conditions treated by a neurologist are Alzheimer’s disease, Parkinson’s disease, multiple sclerosis (MS), various forms of dementia, sleep disorders, headaches, brain tumours, strokes, seizures, myalgias, myasthenia gravis and neuropathy.
MRI and CT are tests that are frequently ordered by neurologists and neurosurgeons for brain and spinal cord imaging. These are wonderful technologies which provide superb pictures of the brain and spinal cord structure, but require a neurologist or neurosurgeon to understand the significance of the results in terms of each neurology patient’s complaints. The neurologist or neurosurgeon will review the scans and then advise the patient if medical or surgical treatment is indicated, based on the imaging and clinical findings.
“Neurophysiology” is a branch of neurology that uses the electrical output of the nervous system, to aid in the diagnosis and treatment of disorders such as seizures, carpal tunnel syndrome, “trapped spinal nerves”, dystonia, neuropathy and myopathy. Neurophysiological testing includes EEG, nerve conduction studies, EMG and evoked potentials. These tests provide detailed functional information on the working of an individual’s nervous system and where a problem is located. Neurologists and neurosurgeons make treatment decisions based on the patient’s complaints and the results of the neurophysiological and radiological investigations.
Many diseases and conditions treated by a neurologist are treated with medication and/or physical therapy, occupational therapy and other procedures. If your condition necessitates surgery, the neurologist will refer you to a neurosurgeon. Our neurologists and neurosurgeons, in the department of Neurosciences, work together with specialized nurses, physical therapists and occupational therapists and neuropsychologists to provide a holistic, multidisciplinary approach to the care of neurology patients.
Disorders treated by a Neurologist:
- Neuromuscular Disorders
- Parkinson’s disease
- Trigeminal Neuralgia
- Multiple Sclerosis
- Epilepsy / Seizure Disorders
- Sleep disorders
- Functional Neurological Disorders