THE DIAGNOSIS AND TREATMENT OF CONDITIONS AFFECTING THE NERVOUS SYSTEM
A neurologist is a medically qualified doctor dealing with disorders of the nervous system. This includes the diagnosis and treatment of all categories of disease that involve the central, peripheral and autonomic nervous systems.
Neurologists also manage conditions that affect the coverings of the brain (the meninges), the blood supply of the nervous system and muscles (as these are controlled by the nervous system).
Neurologists in the UK often develop an interest in particular neurological disorders, such as dementia, movement disorders, headaches, epilepsy, sleep disorders, chronic pain management, or neuromuscular diseases, however neurologists in the UK, who are on the GMC specialist register for neurology, will have had comprehensive training in all of these areas.
Common reasons for seeking advice might be because you have symptoms such as a headache, numbness or weakness, transient loss of consciousness or awareness (“fits” or “faints”), unsteadiness, tremors and other abnormal movement as well as memory disorders.
When surgical intervention is required, a neurologist may refer the patient to a neurosurgeon.
Dr Paviour has a close working relationship with a number of neurosurgical colleagues in central London and can advise on the best person to see if that is required.
What to expect during a consultation
During a neurological consultation, Dr Paviour will enquire about the nature of the main symptoms you experience currently.
Dr Paviour will review any previous medical problems you may have had and enquire about current and past medical treatments.
Dr Paviour may enquire about any conditions that run in the family.
You will have a physical examination which will focus on the functioning of the nervous system and this will probably mean testing muscle strength and coordination, sensation and balance, vision and eye movements, as well as speech, language function and higher mental functions where appropriate.
The information obtained from the history of your problem and from examining you will help to determine what the problem is and what part of the nervous system it affects.
Further tests may be needed to confirm a diagnosis and ultimately guide any treatment.
These may include blood tests, imaging of the nervous system (MRI or CT) and electrical testing of nerves and muscles (EMG) or brain function (EEG).
If your insurer is covering the costs of your consultation and treatment, you may wish to check that investigation costs will be covered.
A new appointment will take approximately 30 minutes and a follow up 10-20 minutes. Most patients will need a follow up appointment to review the results of any tests or to judge response to any treatment started.
An MRI scan is a Magnetic Resonance Imaging scan. It uses strong magnetic fields and radio waves to take pictures of the brain or spine.
It differs from a standard X-ray as it produces very detailed pictures of the brain or spine.
Nerve conduction studies
Nerve conduction studies give doctors information about how well and how fast the nerves in your body send electrical impulses. This test can be used to check for various different types of problems with the peripheral nervous system. The peripheral nervous system includes all the nerves in your body apart from those in your brain and within the spinal cord itself. Nerves in the brain and spinal cord make up the central nervous system.
An electromyogram (EMG) measures the electrical activity of muscles at rest and during contraction. Nerve conduction studies measure how well and how fast the nerves can send electrical signals. Nerves control the muscles in the body with electrical signals called impulses.
An electroencephalogram (EEG) is a recording of brain activity. During the test, small sensors are attached to the scalp to pick up the electrical signals produced when brain cells send messages to each other. These signals are recorded by a machine and are looked at by a doctor later to see if they’re unusual.