Neurology in United States

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 United States?

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 United States 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 United States

About the United States

With a population of over 327 million people, the United States of America (USA) is the third most populous country in the world. It has endless options for visitors with beaches, snow-covered mountains, forests, big cities; travelers will have many different experiences. The country is also a top global destination for medical travel. Although procedures can cost a lot more when compared to Asian countries, people from all over the world come to the United States to get treated with advanced technology and competent medical professionals. The skilled and experienced doctors are mostly trained in world-renowned universities including Stanford and Harvard. Medical tourists come from the Caribbean, Europe, and Central America and almost any procedure can be done in the country, whether it is complex procedures or a difficult diagnosis.  

Popular Parts of the United States

• New York City is home to various iconic landmarks. Tourists will find world-famous sites around every corner and there are just so many things that tourists should not miss, such as the Statue of Liberty, Times Square, the Staten Island Ferry, Empire State Building, the Brooklyn Bridge, and MoMA. Art is an essential part of the city and museums devoted to every type of art is available from Japanese sculpture, medieval European treasures, to Himalayan textiles. The city is also known to have an incredible food scene. Tourists are welcome to dine at one of the city’s 74 Michelin-starred restaurants or try the food trucks. At night, the city comes alive with the legendary theater of Broadway, burlesque performance, ballet, music, and so many more.
• Los Angeles is home to Hollywood, natural beauty, and architecture. It is filled with movie stars, musicians, and surfers. Tourist who loves film will be delighted to tour TCL Chinese Theatre, the Hollywood Walk of Fame, the Paramount Picture Studios. Most tourists will enjoy relaxing in Venice Beach, Zuma Beach, and the Santa Monica Pier and Beach. Tourists can also take a day trip to the “Happiest Place on Earth,” Disneyland-Anaheim, wander around Griffith Park, or see the beautiful Getty Museum.
• Dallas is a cosmopolitan city that is overflowing with culture and pride. The city is famous for Cowboys, cheerleaders, and unique attractions. Museums are probably the best points of interest in the city, including the Sixth Floor Museum and Perot Museum of Nature & Science. Tourists also have many options to hang out in since the city is filled with trendy restaurants, boutiques, and cafes. If you want to see some beautiful flowers, visit the Dallas Arboretum. It is a beautiful botanical garden that showcases plants and flowers in themed gardens.
• Chicago is a city of many things. Whether you want to visit jazz clubs, fine dining, admire its skyscrapers, or go shopping, you will find something to do in this city. Some of the top attractions are Hancock Observatory, Shedd Aquarium, Millennium Park, and Lincoln Park Conservatory and Zoo. Everywhere you walk, you will find astonishing art and architecture, such as an abstract Picasso statue and the Museum of Mexican Art.

Weather and Climate in the United States

The United States has a wide variety of climates, which makes it a year-round destination. In general, the country experiences four distinct seasons. Summer starts in June and ends in August. During the summer, the northern states enjoy warm days and cool nights, and the southern states and tropical areas experience very hot temperatures. Autumn is from September to November and the season brings cooler temperatures to the country. December to February is the winter months and the northern areas will encounter snow and colder temperatures, but the southern areas experience mild temperatures. The temperatures all around the country will begin to warm up during the spring months from March to May and expect to find many thunderstorms and rainstorms during this season.

Getting Around in the United States 

The United States is well connected by plane since it has more than 375 domestic airports and numerous international airports. Most tourists will arrive in Hartsfield-Jackson Atlanta, John F. Kennedy International Airport, or O’Hare International Airport. These airports serve domestic and international flights to many parts of the world. The airports also operate many carriers such as Delta Air Lines, JetBlue, United, and American Airlines. 

The most affordable way to get around the USA is by bus. Many bus companies go across the country such as Greyhound, Mega Bus, Peter Pan, and Bolt Bus. However, it is important to note that long-distance travel can take a long time. The nicer option to travel around the country is by Amtrak trains. It is by no means fast, but tourists can relax and enjoy the landscape. If you wish to travel by train, tourists can purchase money-saving passes. The most popular way to travel around the USA is by car. Petrol is generally cheaper compared to the United Kingdom and it gives tourists the freedom to go wherever they want. Taxis are plentiful in most cities and can be very inexpensive. Many taxis are painted in bright yellow, making them easy to distinguish. Taxi can be hailed directly from the streets and the fare is run on a meter.

Tourist Visas in the United States

All visitors must obtain a visa to visit the United States of America unless they come from one of the visa-exempt or Visa Waiver Program countries. There are four countries and Bermuda that have visa exemption access to the US. Currently, citizens of 38 countries are selected for the Visa Waiver Program, including Australia, Japan, Singapore, and the United Kingdom. Other nationals not listed in the visa-exempt or Visa Waiver Program should apply and obtain a visa before entering the country. It is advisable to always check with your nearest US Embassy for the visa policy.

Additional Information

1. Local Currency: The official currency is the US dollar ($). It is known as a ‘global currency.’ Check XE.com for the current exchange rate to your local currency.
2. Money & Payments: ATMs are available almost everywhere around the country. Major credit and debit cards are universally accepted in restaurants, hotels, shops. Credit cards are required to book domestic flights. Tipping is not optional, so make sure to always leave some tips. 
3. Local Language: The main language in the country is American English. Many people will be able to speak Spanish.
4. Local Culture and Religion: The USA is home to many religions and most of the population follows Christianity, but there are small groups of Jews and Muslims. 
5. Public Holidays: Some of the most celebrated holidays in the USA are New Year’s Day, Independence Day, US Indigenous People’s Day, Thanksgiving, and Christmas Day.