Neurologists diagnose, treat and manage disorders that affect the central nervous system (the brain and spinal cord) and the peripheral nervous system (nerves and muscles which activate movement and transmit sensation from all parts of the body to the brain).
Nature of the work:
Neurologists treat any disease of the body’s systems that affects neurological function. High blood pressure, for example, is a cardiac problem, but if it causes a stroke (a sudden loss of blood supply to the brain) the problem becomes a neurological one as well.
Neurologists also treat infectious disease such as meningitis which can cause brain damage and lead to complications like epilepsy.
They also treat peripheral nerve diseases which may result in weakness or sensory impairment.
In many cases, the diagnosis of new patients with neurological problems is by clinical assessment alone (taking a thorough history of the symptoms and physical examination), though in others there may be a need for further investigation such as blood tests, scans (CT or MRI) and electrical tests which measure peripheral nerve and muscle function.
Patients are followed up either to clarify the diagnosis or alternatively to manage longer term problems. Examples of conditions which require long term follow-up are epilepsy, multiple sclerosis and Parkinson’s disease.
The process of diagnosis is becoming ever more sophisticated with improved imaging and other types of tests including genetic testing. Available treatments are broadening too with improvements in existing therapy as well as new treatments such as those to modify the disease in multiple sclerosis.
Neurologists treat conditions such as:
multiple sclerosisheadaches blackoutsperipheral neuropathy (disease affecting the nerves) including chronic neuropathic painParkinson’s disease and other movement disorders (eg tremor)Alzheimer’s disease and other forms of dementia Amyotrophic Lateral Sclerosis (ALS) also known as motor neuron disease. MND (causing weakness and muscle wasting due to nerve degeneration)epilepsy spinal cord diseases muscle diseases like muscular dystrophy (causing weakness of muscle fibres)myasthenia gravis (where the muscles become weak and tire easily) and related disorders brain tumours functional disorders (symptoms which cannot be explained by neurological damage).
Electroencephalography (EEG) to look for signs of epilepsy Nerve conduction tests (neurophysiology)injections for the treatment of patients with dystonia (abnormal muscle contractions)rarely, muscle or nerve biopsies.
Common reasons to visit a neurologist:
A thorough neurological exam is the most important tool I have as a neurologist,” Dr. Bruce explains. “It can help differentiate and localize the causes of common complaints.”
Chronic or severe headaches:
If you get migraine headaches, you should probably make an appointment with a neurologist, especially when the symptoms are associated with neurological deficits or tried treatments prove ineffective.
Experiencing vertigo (feeling like you’re spinning) or having difficulty keeping your balance could be a sign of something more serious.
Numbness or tingling:
Numbness or tingling, especially when it occurs on one side of the body or comes on suddenly, could be a sign of a stroke or other serious condition.
Difficulty walking, shuffling your feet, tremors and unintentional jerks, can all be signs of a nervous system problem.
Memory problems or confusion:
Worsening memory problems, personality changes or mixing up words could be signs of Alzheimer’s disease.
What is Functional Neurology?
Functional Neurology is a new concept for many people. In essence, functional neurology, also called chiropractic neurology, is the clinical evaluation and treatment method for the central and peripheral nervous system. Very basically, functional neurology can be thought of as exercise for the brain. Just like training a muscle makes it stronger, training your brain will make it stronger.
What does it mean to make the brain stronger? By this, we mean improve the function of the brain. This can be achieved by making positive neuroplastic changes. Neuroplasticity is the term that describes the brains ability to make new connections in order to achieve a new function. Think about a developing child learning to walk or talk or write. It takes practice, but once the task is learned, it is hard wired. Through trauma, degeneration, or a developmental obstacle, the brain may not be wired correctly or it may have a weak or broken wire. A functional neurological treatment is one that promotes rewiring and/or strengthening a connection that is already in place.
Functional neurology is brain training. Smell, taste, sound, balance, vision, movement, and touch are utilized in specific ways to promote neuroplastic changes. Making a positive neuroplastic change requires specificity. Treatment needs to be specific for the part of the brain requiring change and then the treatment intensity needs to be done within the brain’s metabolic capacity. When working with fragile or broken wires (neurons), it is easy to cause more damage if the ‘weight’ of the treatment is not closely monitored.
Functional neurology does not include surgery or pharmaceutical solutions, but may employ some combination of chiropractic manipulation, various therapies, and recommended lifestyle changes.
The explanation which functional neurology provides for neurological disorders is still a hypothesis and difficult to convey in plain language, but here’s the short version based on a recent review of functional neurology.
Functional neurology treats the source of a patient’s ailments as “functional aberrations of the neuraxis” — meaning, clusters of neurons which aren’t working together in the way they are supposed to — in various locations throughout the central nervous system.
Functional neurologists attempt to assess the “central integrative state,” or CIS, of functional units of neurons within the nervous system to determine where those functional aberrations are. The CIS is essentially how they refer to the current healthiness of those neurons.
Functional neurologists believe functional aberrations come from lesions, which are the result of some deficiency — perhaps there are dead cells (worst case scenario), or maybe they aren’t getting enough oxygen or nutrition.
Whatever the case, these aberrations cause communication snafus throughout the central nervous system and lead to hyper- or hypo-functional areas of the brain. In turn, this situation results in “diverse motor, sensory, visceral, or cognitive symptoms”.
Many functional neurologists are also interested in fatigability (can you maintain a healthy response to a certain stimulus?) and hemisphericity (the belief that neurological symptoms come from some imbalance between the two halves of the brain or an area therein).
While their treatment protocols are highly varied, many functional neurologists base treatment on the idea that stimulation of an area is enough to engage the brain’s inherent neuroplasticity, which is its ability to heal itself from certain injuries and conditions.
For the purposes of this piece, we will assume that functional neurologists begin with chiropractic training. Chiropractors spend years learning about the central nervous system and the spine. They spend more time during diagnosis and treatment looking at whole-body care and the effects of lifestyle on health than do most neurologists.
To become a chiropractic neurologist, they complete additional coursework on neurological disorders and the functional neurology approach to treating them.Functional neurologists are in their element while treating symptoms of unknown cause, especially if they are related to the vestibular (balance) system. They can also help patients with neck soreness, back pain, and other symptoms relating to the spine because of their chiropractic training.