Definition and Overview

Neurology consultation is an appointment with a neurologist for the diagnosis, management, or treatment of conditions that affect the nervous system. A healthcare professional who specializes in neurology is called a neurologist.

Neurology is the branch of medicine that deals with the nervous system, which is divided into two categories: peripheral and central. The central nervous system is composed of the brain and the spinal cord. The nerves, on the other hand, make up the peripheral as they branch out to various organs such as the eyes and limbs.

The nervous system plays a huge role in a person’s ability to move. The brain acts as the “command center” telling the different parts of the body on how to move or respond to certain situations, as well as receive signals from these body parts. The nerves, on the other hand, serve as the communication pathway between the body part and the brain. As an example, the lining of the bladder is composed of nerves that send signals to the brain when the organ is already full of urine. The brain then tells the bladder to release the urine.

Meanwhile, the spinal cord provides a seamless “highway” for the transmission of signals. When it is injured or diseased, for example, the communication may be disrupted, which then results in poor body coordination, among others.

Many factors can affect how the nervous system works, including genetics, hormones, and congenital deformities. Certain diseases may also directly or indirectly affect the nervous system. A neurology consultation helps to identify the condition, rule out a neurological disease, treat the problem, or manage it, especially if it does not have a cure or tends to be progressive.

Who Should Undergo and Expected Results

More often than not, those who see a neurologist are patients who have been referred by their family care doctor, general physician, or emergency doctor. It is, therefore, possible that first-line treatments have already been implemented, but the symptoms are getting worse or have not gone away. Also, the disease or condition may be unfamiliar or out of the scope and expertise of the general physician.

Not all neurological conditions exhibit symptoms, but when they do, the patient may be best referred to a neurologist. Some of the most common symptoms include recurrent or frequent headaches, headaches with projectile vomiting, seizure, vision loss, balance disorders, and speech problems. Note that these symptoms do not have to mean neurological disorders, but a consultation can be helpful to understand the underlying disease or overrule certain suspicions.

People who have experienced serious injuries such as vehicle accidents may have to see a neurologist even when there is no headache involved. Problems affecting the brain and skull sometimes do not manifest immediately. Those who have been diagnosed with hypertension or have gone through stroke may also want to see a neurologist. These diseases are usually related to weakened blood vessels that may be found in the brain.

A neurology consultation can be carried out in an inpatient or outpatient setting. The patient may already be in the hospital and the consultation is performed in conjunction with other types of tests and doctor’s appointments.

A consultation with a neurologist usually lasts for at least 30 minutes. Depending on the initial findings of the doctor, tests may be carried out on the same day. However, results are often provided within a couple of days or weeks.

How Does the Procedure Work?

The following procedures are carried out on outpatients:

1.) The patient is referred by the doctor or the insurer based on the results of the physical examination and imaging tests, as well as the patient’s response to any treatment or management plan.

2.) The patient sets an appointment with the neurologist either online or by telephone. One of the staff members should be able to provide the patient the best schedule unless the consultation needs to be urgent, in which case the patient becomes a priority.

3.) Prior to the actual consultation, the neurologist reviews the patient’s medical records and tests.

4.) In the actual consultation, the neurologist may interview the patient regarding:

• Medical and family history
• Presence of symptoms, as well as the severity (Is it progressing? Can it be controlled by medications?)
• Circumstance prior to the appearance of the symptoms
• Medications and treatments undertaken
• Current concern of the patient
• Any existing illness

5.) Usually, based on the interview and the records the patient has provided, the neurologist can have a basic idea of the problem but would recommend tests to confirm it. Sometimes these examinations are required when the initial findings are inconclusive or insufficient.

6.) The neurologist would provide an initial diagnosis, discuss the recommended tests, and give medications or therapies to reduce the symptoms while waiting for the official test results.

The consultation is the best time for the patient to ask questions that may not have been answered by previous doctors. They may also inquire more about the examinations.

7.) Some of the tests may be conducted on the same day. Others have to be scheduled and may not have to be performed by the neurologist himself but by a radiologist or other capable health care professionals. The results are then forwarded to the patient’s neurologist and are discussed in the next consultation.

8.) If the patient is provided with treatment or management plan including medications, the patient may have to see the neurologist at certain times for monitoring.

Possible Risks and Complications

A neurology consultation is generally safe as well as the tests that may have to be conducted to make a diagnosis. Perhaps the biggest challenge is when the treatment does not work in which case reevaluation, or new treatment should be provided. The process can be frustrating for the patient. Sometimes too the diagnosis may not be what the patient expects. Patients are allowed to request for a second opinion from another neurologist in such cases.

References:

• International Journal of Neurology Research
• World Federation of Neurology