Neurology in Turkey

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 Turkey?

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 Turkey 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 Turkey

About Turkey

Where East meets West – Turkey is considered to be both Asia and Europe, with 95% of its landmass being located in Asia. Rich in culture and history, a land once inhabited by some of history’s greatest empires, including most recently the Ottoman Empire and long before that, the Roman and Byzantine Empires. Of Turkey’s 1,200+ medical facilities, of which many are JCI-accredited and this includes an even mix of publicly and privately owned hospitals and clinics.

700,000 annual medical tourists are drawn to Turkey each year, traveling from all across the globe, particularly from within Europe and the Middle East, many of which travel for Neurology procedures. Dental, Cosmetic, Bariatric, and Reproductive procedures are most common, including Veneers, Hair Transplants, Gastric Bypass Surgeries, and IVF. Popular medical tourism destinations outside of the capital, Ankara, of course, include Istanbul and other regions like Antalya and Izmir.

Popular Parts of Turkey

With a population of around 85 million, Turkey has a landmass of nearly 800,000 square km. The capital city is Ankara, located inland, however, Istanbul is the most populous and most recognized city in Turkey with some 15 million inhabitants. Straddling both Europe and Asia, the city attracts 13 million tourists each year, making it the fifth most popular tourist destination in the world.

Additional well-frequented locations encompass Antalya nestled in the southern part of the country, as well as Izmir perched in the west. Paradoxically, the eastern region of the country sees less influx of tourists. One major contributing factor is the enduring Kurdish-Turkish conflict, exacerbated further owing to its geographical closeness to conflict-laden nations such as Syria and Iraq.

Sun-chasers seeking a blend of affordability and indulgence invariably find themselves drawn to the southern holiday resorts like Marmaris and Bodrum. These locales are a magnet for those yearning for 5-star luxury hotels, offered at reasonable prices and with all-inclusive perks, for their vacation getaway.

The discovery of the world’s oldest known megalithic site at Gobekli Tepe in the South-Eastern Anatolia Region has cast much doubt over mankind’s ancient history and consequently attracts a sizable number of ‘History Tourists’. This UNESCO World Heritage Site is believed to be over 11,000 years old, built during a time humans were understood to be simple hunter-gatherers.   

Weather and Climate in Turkey

Enjoying a Mediterranean location, Turkey's south coast is graced by refreshing sea breezes. Despite this, the summer months from June through August witness soaring heat with temperatures often climbing into the 40s (104°F). The transitional seasons of spring and autumn bring more temperate weather, and winters are quite mild.

Turkey's vast expanse leads to a variety of weather patterns across its regions. The central parts of the country predominantly feature a semi-arid steppe climate, while the northern Black Sea region showcases far milder conditions compared to the southern Mediterranean Sea region.

Do take note of the potential problem of mosquitos and sandflies, particularly during summers in coastal areas. It's advisable to take proper protective measures against them. Though malaria cases are extremely rare, always consult a healthcare professional for appropriate advice before embarking on your trip.

Getting around in Turkey

Istanbul’s famous Ataturk International Airport sits 24 km outside the city and is home to the ever-popular Turkish Airlines. Most other major airlines service Ataturk, which is often used as a stopover destination for travelers between Europe and Asia. All the other major cities are serviced by their own international airports, with several low-cost domestic airlines joining them together, including AtlasGlobal, IZair, Onur Air, Pegasus Airlines, and SunExpress.

For those preferring to travel by land, Turkey has a few express train routes linking the major cities, most notably, Istanbul to Ankara. City buses are reliable and good value, whilst taxis are cheap, but be sure to negotiate the price before beginning any journey.

Tourist Visas in Turkey

Visa restrictions are relatively light, with a 90-day per visit allowance readily available for many nationalities. Still, e-visas need to be procured in advance, for a fee, by travelers hailing from countries such as the US, UK, Australia, China, and Spain. Conversely, passport holders from countries including France, Germany, Russia, and Singapore are granted visa-free entry.

For nationals from India and Pakistan, conditional e-visas are offered upon arrival, but solely at Ataturk International Airport. These visas have a validity of just 30 days. For comprehensive information on visa requirements, it is recommended to visit the Ministry of Foreign Affairs website.

Additional Information

1. The Turkish Lira (TRY) is the local currency where $1 USD is worth about 18 TRY, having experienced heavy fluctuations recently.
2. ATMs are in abundance across Turkey and accept all bank cards (Visa, Mastercard). Credit card and Amex payments are accepted in most restaurants and outlets, with more local food vendors or food market stalls, only accepting cash. Tipping is expected as service is not included at restaurants, this is usually between 5-10%. Taxi rides tend not to be tipped, just rounded up.
3. Turkish is the local language with the eastern Kurds speaking Kurdish too. English is spoken by many locals working in tourist locations, including major cities.
4. Islam (99.8%) is by far the main religion in Turkey, with a tiny Christian population (0.2%). Turkey is, however, a secular country where there is no ‘official’ state religion. Various elements of traditional culture remain, with much being modernized or ‘Westernized’.
5. There are many public holidays, most notably Labor Day and Commemoration of Ataturk in May, Ramazan Feast in June, Kurban Bayrami in August, and Republic Day at the end of October.