Neurology is a medical specialty dealing with disorders of the nervous system. Specifically, it deals with the diagnosis and treatment of all categories of disease involving the central, peripheral, and autonomic nervous systems, including their coverings, blood vessels, and all effector tissue, such as muscle. Physicians who specialize in neurology are called neurologists, and are trained to investigate, or diagnose and treat, neurological disorders. Pediatric neurologists treat neurological disease in children. Neurologists may also be involved in clinical research, clinical trials, as well as basic research and translational research.
Major Neurological Conditions
Neurological disorders are disorders that affect the central nervous system (brain and spinal cord), the peripheral nervous system, or the autonomic nervous system.
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- disorders of peripheral nerves, muscle (myopathy) and neuromuscular junctions
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- headache disorders such as migraine, cluster headache and tension headache
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- neurodegenerative disorders, including Alzheimer's disease, Parkinson's disease, Huntington's disease, and Amyotrophic lateral sclerosis (Lou Gehrig's disease)
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- movement disorders such as Parkinson's disease, Huntington's disease, hemiballismus, tic disorder, and Gilles de la Tourette syndrome
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- cerebrovascular disease, such as transient ischemic attack and stroke
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- demyelinating diseases of the central nervous system, such as multiple sclerosis, and of the peripheral nervous system, such as Guillain-Barré syndrome and chronic inflammatory demyelinating polyneuropathy (CIDP)
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- speech and language disorders
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- infections of the brain (encephalitis), brain meninges (meningitis), spinal cord (myelitis)
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- neoplasms - tumors of the brain and its meninges (brain tumors), spinal cord tumors, tumors of the peripheral nerves (neuroma)
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- traumatic injuries to the brain, spinal cord and peripheral nerves
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- altered mental status, encephalopathy, stupor and coma
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- spinal cord disorders - tumors, infections, trauma, malformations (e.g., myelocele, meningomyelocele, tethered cord)
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- behavioral/cognitive syndromes
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Educational requirements
Neurologists are physicians who have completed a four year residency in neurology after the completion of medical school and attainment of the MD degree.
Neurologists complete a total of 12 years of postsecondary education and clinical training. This training includes obtaining an undergraduate college degree, a medical degree (four years), and then completing a four-year residency in neurology. The four-year residency consists of one year of internal medicine training followed by three years of training in neurology.
Clinical tasks
Neurologists are responsible for the diagnosis, treatment, and management of all the above conditions. When surgical intervention is required, the neurologist may refer the patient to a neurosurgeon, an interventional neuroradiologist, or a neurointerventionalist. In some countries, additional legal responsibilities of a neurologist may include making a finding of brain death when it is suspected that a patient is deceased. Neurologists frequently care for people with hereditary (genetic) diseases when the major manifestations are neurological, as is frequently the case. Lumbar punctures are frequently performed by neurologists. Some neurologists may develop an interest in particular subfields, such as dementia, movement disorders, headaches, epilepsy, sleep disorders, chronic pain management, multiple sclerosis or neuromuscular diseases.
There is some overlap with other specialties, varying from country to country and even within a local geographic area. Acute head trauma is most often treated by neurosurgeons, whereas sequela of head trauma may be treated by neurologists or specialists in rehabilitation medicine. Although stroke cases have been traditionally managed by internal medicine or hospitalists, the emergence of vascular neurology and endovascular neurosurgery as disciplines has created a demand for stroke specialists. The establishment of JCAHO stroke centers has increased the role of neurologists in stroke care in many primary as well as tertiary hospitals. Some cases of nervous system infectious diseases are treated by infectious disease specialists. Most cases of headache are diagnosed and treated primarily by general practitioners, at least the less severe cases. Similarly, most cases of sciatica and other mechanical radiculopathies are treated by general practitioners, though they may be referred to neurologists or a surgeon (neurosurgeons or orthopedic surgeons). Sleep disorders are also treated by pulmonologists. Cerebral palsy is initially treated by pediatricians, but care may be transferred to an adult neurologist after the patient reaches a certain age.
Clinical neuropsychologists are often called upon to evaluate brain-behavior relationships for the purpose of assisting with differential diagnosis, planning rehabilitation strategies, documenting cognitive strengths and weaknesses, and measuring change over time (e.g., for identifying abnormal aging or tracking the progression of a dementia).
