Neurology is the branch of medicine dealing with disorders of the brain, and central, peripheral and autonomic nervous systems. It also deals with the examination of nerve coverings and associated blood vessels and muscles. Neurology relies heavily on the field of neuroscience, which is the scientific study of the brain and nervous system.
A neurologist is a doctor, usually employed in a hospital, specialising in neurology and trained to diagnose and treat neurological disorders. Neurologists may also be involved in research, clinical trials and academic teaching. There is also overlap with neurosurgery, psychiatry and neuropsychology, and often a neurologist will liaise between these disciplines when treating patients.
In Australia, patients are usually referred to a neurologist by a general practitioner or Accident and Emergency doctors. Neurologists begin by taking a comprehensive medical history and then performing a physical examination focusing on evaluating the nervous system. Components of the neurological examination include assessment of the patient’s cognitive and verbal function, cranial nerves, motor strength, sensory ability, reflexes, coordination and walking gait. Then neurologists may order additional diagnostic tests, such as blood tests or genetic tests for specific neurological disorder markers, and examine cerebrospinal fluid pathology. Other commonly employed tests include diagnostic imaging such as computed axial tomography (CAT) scans, positron emission tomography (PET), functional magnetic resonance imaging (fMRI), and ultrasound of major blood vessels of the head and neck. Neurologists may also require neurophysiologic tests such as electroencephalography (EEG), needle electromyography (EMG), and nerve conduction studies (NCSs).
Some of the commonly encountered conditions treated by neurologists include headaches, radiculopathy, neuropathy, stroke, dementia, epileptic seizures, Alzheimer’s disease, Parkinson’s disease, Tourette’s syndrome, multiple sclerosis, head trauma, sleep disorders, neuromuscular diseases, and various infections and tumours of the nervous system. Neurologists are also asked to evaluate unresponsive patients on life support to confirm brain death.
Treatment options available to a neurologist depend upon the neurological problem but include referring the patient to a physiotherapist, prescribing medications or recommending radiotherapy or surgery.
Some neurologists specialise in certain parts of the brain and nervous system or in specific procedures.
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Expertise in Action
Experts in neurology can offer opinions in assessing diseases of the brain and nervous system as well as brain injuries in civil and criminal cases.
Furthermore, they may be required to assess the actions and procedures of other neurologists and the general medical care of nursing staff and hospitals in cases of alleged misdiagnosis, negligence and malpractice.
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The overall cost of expert opinion depends on the services required. Some of the key factors that affect the cost of advice include:
- The need for a view or inspection of a location
- The quantity of documentary material to be reviewed
- Whether there are reports of other experts to be reviewed and commented on in detail
- Whether there is a need for conferences with the expert either in person or by telephone/Skype