Neurology in Taiwan

Neurology is a branch of medicine that focuses on the diagnosis and the treatment of diseases of the nervous system. The nervous system is a complex and sophisticated system that regulates and coordinates our body activities. It is divided into two major parts:

• The central nervous system: the brain and spinal cord
• The peripheral nervous system: all nerves branching out from the brain and spinal cord, and extend to other parts of the body, including organs and muscles.

Since the nervous system is complex, there are numerous subspecialties within the field of neurology, including:

• Neurodevelopmental disabilities
• Pediatric or child neurology
• Neuromuscular medicine
• Pain medicine
• Hospice and palliative care neurology
• Headache medicine
• Vascular Neurology (stroke care)
• Sleep medicine
• Autonomic disorders
• Brain injury medicine
• Neuropsychiatry
• Epilepsy
• Neurointensive care

A doctor who specializes in treating diseases of the nervous system is called a neurologist. Symptoms that often require a neurologist help may include coordination problems, muscle weakness, confusion, dizziness, and a change in sensation. People who are having problems with their senses, such as vision, touch, or smell, may also require to see a neurologist since problems with senses are sometimes caused by disorders of the nervous system.

A neurologist may also treat patients with:

• Stroke
• Seizure disorders, such as epilepsy
• Migraines and headaches
• Brain aneurysms
• Brain tumors
• Peripheral neuropathy
• Multiple sclerosis
• Infections of the nervous systems, such as meningitis, encephalitis, or brain abscesses
• Neuromuscular disorders, such as myasthenia gravis
• Neurodegenerative disorders, such as Alzheimer’s disease and Lou Gehrig’s disease
• Sleep disorders
• Spinal cord disorders, such as autoimmune and inflammatory disorders
• Speech and language disorders

Keep in mind that neurologist does not perform surgery. If you need surgery, you will be referred to a neurosurgeon.

What does Neurology Involve?

A wide variety of different tests and procedures are used to diagnose and treat neurological conditions. On your first appointment with a neurologist, a physical and neurological exam is likely to be performed. A neurological exam is done to test muscle strength, coordination, and reflexes.

Because different diseases can have similar symptoms, more than one testing may be required for your neurologist to make a diagnosis.

Some of the procedures that fall into the field of neurology may include:

Electromyography

Electromyography (EMG) is used to measure how well your muscles react to electrical stimulation from motor neurons, which are specific nerves controlling muscle movement. It can help neurologists diagnose general muscle or nerve dysfunction, as well as spinal cord disease.

During an EMG, small needles called electrodes are inserted into the muscle by a specially trained technician. The electrodes can measure the different electrical activity occurring in muscle tissue during periods of movement and rest.

Electroencephalogram

Electroencephalogram (EEG) is performed to assess and record electrical activity in your brain. Neurons in our brain communicate with other neurons through electrical impulses, which an EEG can record. Brain wave patterns can also be tracked by an EEG. It is used to help diagnose conditions of the brain, including tumors, inflammation, injuries, as well as psychiatric disorders, epilepsy, and seizures.

During an EEG, electrodes are placed on your head. The electrodes are connected to a computer, which converts electrical signals into patterns that can be seen from a screen or printed on a piece of paper.

Lumbar puncture

Lumbar puncture is done to test your spinal fluid. It involves inserting a needle into your spine after numbing it with an anesthetic. Using the needle, a sample of your spinal fluid is taken.

A lumbar puncture can help diagnose the following conditions:

• Meningitis
• Encephalitis
• Leukemia
• Myelitis
• Dementia
• Autoimmune diseases, such as multiple sclerosis (MS)
• Bleeding in the brain

The procedure can also be used to treat conditions affecting the spinal cord. Your neurologist may inject anesthetics, cancer treatments, or antibiotics using a lumbar puncture needle.

Tensilon test

To help diagnose myasthenia gravis, your neurologist may perform a tensilon test. It involves the injection of a medicine called Tensilon. Then, your neurologist observes how medicine affects your muscle movements.

Sleep study

Chronic sleep problems are diagnosed in a Sleep Study. Also known as a Polysomnogram (PSG), this procedure involves monitoring patients during sleep and physiological data is recorded electronically.

Other tests

Other types of tests may be used by your neurologist to make a diagnosis. These may include:

• Magnetic resonance imaging (MRI scan)
• Computed tomography (CT scan)
• Positron emission tomography (PET scan)
• Biopsy
• Genetic testing
• Angiography

Botox injections

Botox injections can be done to treat some neurological conditions, such as cerebral palsy, that can cause your limbs to pull in toward your center. Sometimes, these contracted muscles can be relaxed with Botox injections.

Botox injections involve injecting tiny amounts of botulinum toxin into your skin of muscles using a thin needle.

Brain tumor treatment

A range of treatments can be done to treat a brain tumor. If your neurologist believes that you need surgery, you will be referred to a neurosurgeon who will remove as much of the brain tumor as possible through surgery.

A brain tumor may also be treated with radiation therapy, which uses high-energy beams to kill tumor cells.

Brain tumor treatment may be integrated between the departments of neurology and oncology.

Brain rehabilitation therapy

Brain rehabilitation therapy is used to help you relearn functions that are lost as a result of a brain injury. Brain rehabilitation therapy is usually integrated between specialty teams in the departments of neurology, sports medicine, psychiatry and psychology, neuroradiology, and the vestibular/balance laboratory.

Deep brain stimulation

During deep brain stimulation, electrodes are implanted within certain areas of the brain. The electrodes generate electrical impulses that can regulate abnormal impulses. These electrical impulses may also affect certain chemicals and cells within the brain.

Deep brain stimulation can be done to treat numerous conditions, including dystonia, essential tremor, epilepsy, and Parkinson’s disease. It is also being studied as a potential treatment for multiple sclerosis and stroke recovery.

Spinal stenosis treatment

Spinal stenosis is a condition that occurs when the spinal canal narrows and pinches the nerves, leading to back and leg pain. Spinal stenosis may be treated with pain medications, physical therapy, steroid injections, decompression procedure, or surgery. Surgery is usually performed if other treatments have not helped.

How Long Should I Stay in Taiwan?

Your length of stay depends on the type of procedure you have, you may be allowed to leave the hospital on the same day or you will stay for several days. For diagnostic procedures, you should be allowed to leave the hospital on the same day. However, you should wait until the results of the test are ready before you can fly home, which may take as long as 7 days, sometimes even longer. If you undergo brain tumor treatments or other types of treatment, especially treatments that involve surgical intervention, you should aim to stay in Taiwan at least for 10 days.

What's the Recovery Time?

The recovery time can be different for each procedure. It may also depend on the reason why you are having the procedure and your overall health. Your neurologist and neurosurgeon will give you a recovery timeline for each procedure. The recovery period for diagnostic procedures is typically short and you may be able to resume your normal activities within a week or so. For surgical procedures, you may need to wait 4 weeks or months until you can go back to your daily routine, including work and exercise.

What About Aftercare?

A detailed aftercare instruction will be given to you following your procedure. While the instructions will be different for each procedure, they typically include a diet plan, exercise, restrictions, and wound care (if any surgical intervention is involved). You should follow these instructions carefully in order to have a speedy and smooth recovery.

You may also need to attend follow-up checkups to monitor your overall condition and healing. For brain tumors, you may need to attend regular checkups to ensure the tumor has not come back.

What's the Success Rate?

The field of neurology is constantly advancing. The success rate of each procedure is typically high, particularly when performed by highly skilled and experienced medical professionals. Still, some procedures may carry some risks, such as bleeding, infection, and nerve injury.

Are there Alternatives to Neurology?

Since neurology is the branch of medicine to diagnose and treat problems of the nervous system, there are no other alternatives. However, if your doctor found that your disease or illness is found to be caused by other problems unrelated to the nervous system, your doctor will recommend you to see the relevant doctor.

Neurology in and around Taiwan

About Taiwan

Whilst still a part of the Republic of China, the small island of Taiwan maintains a wealth of ancient Chinese culture and traditions mixed with modern-day Western inspirations. With its food-loving locals and award-winning whiskeys, Taiwan is a land of surprises. With 14 JCI accredited facilities in Taiwan, Taipei, the capital, is home to most, many of which are part of the University Hospitals and offer a range of specialist tertiary care. The country welcomes an ever-increasing number of medical tourists each year, many of which travel for Neurology procedures. Medical Tourists mostly travel from the mainland or from within the region.

Popular parts of Taiwan

Taiwan is one of the most densely populated countries in the world with 23.5 million inhabitants. The country has amazed tourists with its dynamic cities, vibrant culture, interesting history, and incredible natural scenery.

• Taipei is the capital of Taiwan. It is the financial, political, and cultural center of the country. The city is influenced by Chinese culture as well as Japanese, Southeast Asian, and American. There are many things to enjoy in this city, such as delicious food in Rahoe Night Market, enjoy a bird’s eye view of Taipei from Taipei 101 Observatory, visit the incredible Chiang Kai-shek Memorial Hall, and be inspired by the city’s many museums.
• Kaohsiung is Taiwan’s largest port. It’s an urban city that embraces its cultural venues. The most popular tourist destination is the Lotus Pond, a beautiful artificial lake filled with lotus plants and surrounded by temples. Tourists can also visit Pier-2 Art Center, see the Dome of Light, explore Cijin Island, or visit the Fo Guang Shan Monastery.
• Tainan, as the oldest city in Taiwan, has a fascinating culture and history. For historical sights, tourists can visit the Anping Fort, Anping Tree House, or learn Taiwanese embroidery. The city is now filled with quaint cafes tucked within the alleys.
• Hualien has breathtaking natural beauty. It’s the perfect place for tourists who want to get away from busy cosmopolitan cities. Visit the Eternal Spring Shrine, check out the popular Taroko Gorge, fall in love with Qingshui Cliffs, hike the Shakadang trail, and eat the amazing food.
• Taichung is a lively city located in the west-central part of the island. Taichung offers many unique things to see and do. National Taichung Theater will leave tourists in awe by its beautiful architecture. National Taiwan Museum of Fine Arts, Rainbow Village, Gomei Wetlands, Miyahara, and Fengjia Night Market are among the most popular tourist attractions.

Weather and Climate in Taiwan

• Spring starts in March and lasts until May. The average temperature is between 18°C and 24°C. Early rain showers and thunderstorms begin in this season. Heavy rainfall hit the island around mid-May.
• Summer can get extremely hot and humid with an average temperature of 27°C to 30°C. The season starts from June to August. Summer is also the wet season and typhoons are a real possibility especially in July and August. This is the peak season for tourism.
• Autumn has pleasant weather conditions. The rains decrease and the heat will drop. The season starts from September to November with an average temperature of 21°C to 27°C.
• Wintertime is from December to February and it is the coolest and driest season of the country. The average temperature drops to 16°C - 18°C.  

Getting Around in Taiwan

Taiwan Taoyuan International Airport is the main airport in the country, located about 40km west of Taipei in the Dayuan District, Taoyuan. It is the hub for 6 airlines including two of Taiwan’s major airlines, China Airlines, and EVA Air. It has international connections with almost every country in the world. The airport serves major airlines as well as budget airlines such as Air Asia, Eastar Jet, Air Busan, and Tiger air Taiwan. There are other airports that serve international and domestic flights such as Taichung Airport, Tainan Airport, Siaogang Airport, and Taipei Songshan Airport.

Tourists arriving at Taiwan Taoyuan International Airport have a variety of transport options such as buses, taxis, car rentals, and Taoyuan Airport MRT. Buses are the cheapest option to get to the city center. Tourists who head towards the Taipei 101 area should take Bus no. 1960, while bus no. 1819 and 1961 will take tourists near Taipei Main Train Station.

Taxis are available in Terminal 1 and Terminal 2’ arrivals lobby. The fare is based on a meter and will usually cost around 1,200 TWD (40.50 USD). A journey to the city center takes about 50 minutes and taxis operate for 24 hours.

Taoyuan Airport MRT is the fastest way to reach Taipei’s city center. It will take tourists to Taipei Main Station in 35 minutes and costs 160 TWD (5.40 USD). The MRT operates from 6.05 am to 11.35 pm.

Tourists can travel around Taiwan by normal train (TRA). It is an affordable option; a train ride from Taipei to Kaohsiung costs around 845 TWD. Tourists who need a quicker travel time can opt for Taiwan High-Speed Train (HSR). The train travels from Taipei to Kaohsiung in just 90 minutes.

The cheapest way to travel around Taiwan is by bus. Buses are readily available and will reach small villages and mountain resorts. The country provides Taiwan Tourist Shuttle bus system that offers 42 routes to more than 100 tourist destinations.

Taxis and MRT is the best way to travel around big cities. In Kaohsiung, getting around in a bicycle is the best way to explore as it is one of the most bicycle-friendly cities in Taiwan.

Tourist Visas in Taiwan

Citizens of 65 countries do not require a visa to visit Taiwan and can stay for up to 90 days. Nationals of Turkey can obtain a visa on arrival valid for 30 days. It is best to check to the nearest embassy or consulate for visa requirements. Since January 2016, Taiwan offers an eVisa program for 18 countries including Saudi Arabia, Peru, Oman, and United Arab Emirates.

Additional Information

1. Local Currency: The local currency is the New Taiwanese Dollar (TWD). 1 USD converts to 31.98 TWD.
2. Money & Payments: ATMs are widely available except in villages. They’re usually located in convenience stores and banks. Credit cards are accepted in hotels and top-end restaurants. Always carry cash because small stalls and night market joints only accept cash. Tipping is not mandatory but is still appreciated.
3. Local Language: The national language is Hakka, Mandarin, Taiwanese Hokkien, Matsu, Formosan languages, and sign language. English is common, especially in the tourism area. English is spoken more in Taipei.
4. Local Culture and Religion: Taiwan has diverse religious beliefs. Buddhism and Taoism are two of the biggest religion in the country followed by Christianity, Yiguandao, Tiandism, Miledadao, Zailiism, and Xuanyuanism.
5. Public Holidays: Taiwan celebrates Chinese New Year for a week in February. The country hosts several festivals such as Lantern Festival in February, Dragon Boat Festival in June, and Mid-Autumn Festival in September.