HOME

TheInfoList




Neurology (from el, νεῦρον (neûron), "string, nerve" and the suffix
-logia ''-logy'' is a suffix in the English language, used with words originally adapted from Ancient Greek ending in (''-logia''). The earliest English examples were anglicizations of the French ''wiktionary:-logie, -logie'', which was in turn inherit ...
, "study of") is a branch of
medicine Medicine is the science Science () is a systematic enterprise that builds and organizes knowledge Knowledge is a familiarity, awareness, or understanding of someone or something, such as facts ( descriptive knowledge), skills (proced ...
dealing with disorders of the nervous system. Neurology deals with the diagnosis and treatment of all categories of conditions and disease involving the
central Central is an adjective usually referring to being in the center (disambiguation), center of some place or (mathematical) object. Central may also refer to: Directions and generalised locations * Central Africa, a region in the centre of Africa ...

central
and
peripheral nervous system The peripheral nervous system (PNS) is one of two components that make up the nervous system In biology Biology is the natural science that studies life and living organisms, including their anatomy, physical structure, Biochemistry, ...
s (and their subdivisions, the
autonomic
autonomic
and
somatic nervous system The somatic nervous system (SNS), or voluntary nervous system is the part of the peripheral nervous system The peripheral nervous system (PNS) is one of two components that make up the nervous system In Biology, biology, the nervous syste ...
s), including their coverings, blood vessels, and all effector tissue, such as muscle. Neurological practice relies heavily on the field of
neuroscience Neuroscience is the scientific study of the nervous system In biology, the classical doctrine of the nervous system determines that it is a Complex system, highly complex part of an animal that coordinates its Behavior, actions and Sens ...

neuroscience
, the scientific study of the
nervous system In biology Biology is the natural science that studies life and living organisms, including their anatomy, physical structure, Biochemistry, chemical processes, Molecular biology, molecular interactions, Physiology, physiological mecha ...

nervous system
. A neurologist is a
physician A physician (American English), medical practitioner (English in the Commonwealth of Nations, Commonwealth English), medical doctor, or simply doctor, is a professional who practices medicine, which is concerned with promoting, maintainin ...

physician
specializing in neurology and trained to investigate, or diagnose and treat
neurological disorder A neurological disorder is any disorder of the nervous system In biology, the classical doctrine of the nervous system determines that it is a Complex system, highly complex part of an animal that coordinates its Behavior, actions and Sen ...
s. Neurologists treat a myriad of neurologic conditions, including stroke, seizures, movement disorders such as
Parkinson's disease Parkinson's disease (PD), or simply Parkinson's, is a chronic condition, long-term neurodegeneration, degenerative disorder of the central nervous system that mainly affects the motor system. The symptoms usually emerge slowly, and as the disea ...
, autoimmune neurologic disorders such as
multiple sclerosis Multiple sclerosis (MS), also known as encephalomyelitis disseminata, is the most common demyelinating disease, in which the Myelin, insulating covers of nerve cells in the Human brain, brain and spinal cord are damaged. This damage disrupts the ...
, headache disorders like
migraine A migraine (, ) is a primary headache disorder characterized by recurrent headaches that are moderate to severe. Typically, episodes affect one side of the head, are pulsating in nature, and last from a few hours to three days. Associated sympt ...

migraine
and
dementia Dementia manifests as a set of related symptoms, which usually surface when the brain is damaged by injury or disease. The symptoms Signs and symptoms are the observed or detectable signs, and experienced symptoms of an illness, injury, or ...
s such as
Alzheimer's disease Alzheimer's disease (AD), also referred to simply as Alzheimer's, is a that usually starts slowly and progressively worsens. It is the cause of 60–70% of cases of . The most common early symptom is difficulty in . As the disease advance ...
. Neurologists may also be involved in
clinical research Clinical research is a branch of healthcare science The following outline is provided as an overview of and topical guide to health sciences: Health sciences – are those sciences which focus on health Health is a state of physical ...
,
clinical trial Clinical trials are experiments or observations done in . Such prospective biomedical or behavioral research studies on are designed to answer specific questions about biomedical or behavioral interventions, including new treatments (such as no ...

clinical trial
s, and
basic BASIC (Beginners' All-purpose Symbolic Instruction Code) is a family of general-purpose, high-level programming language In computer science Computer science deals with the theoretical foundations of information, algorithms and the ar ...
or
translational research Translational research (also translation research, translational science, or translation) is research aimed at translating (converting) results in basic research Basic research, also called pure research or fundamental research, is a type of sci ...
. While neurology is a nonsurgical specialty, its corresponding
surgical Surgery ''cheirourgikē'' (composed of χείρ, "hand", and ἔργον, "work"), via la, chirurgiae, meaning "hand work". is a medical or dental specialty that uses operative manual and instrumental techniques on a person to investigate or t ...
specialty is
neurosurgery Neurosurgery or neurological surgery, known in common parlance as brain surgery, is the medical specialty A medical specialty is a branch of medical practice that is focused on a defined group of patients, diseases, skills, or philosophy. Examp ...
.


Scope

Many neurological disorders have been described as
listed Listed may refer to: * Listed, Bornholm, a fishing village on the Danish island of Bornholm * Listed (MMM program), a television show on MuchMoreMusic * Endangered species in biology * Listed building, in architecture, designation of a historically ...
. These can affect the central nervous system (brain and
spinal cord The spinal cord is a long, thin, tubular structure made up of nervous tissue, which extends from the medulla oblongata in the brainstem to the lumbar region of the vertebral column. It encloses the central canal of the spinal cord, which contain ...

spinal cord
), the peripheral nervous system, the autonomic nervous system, and the
muscular system The muscular system is an organ system An organ system is a biological system A biological system is a complex biological network, network which connects several biologically relevant entities. Biological organization spans several scales and ...

muscular system
. Broadly, neurology covers stroke,
seizure An epileptic seizure, formally known as a seizure, is a period of symptom Signs and symptoms are the observed or detectable signs, and experienced symptoms of an illness, injury, or condition. A sign for example may be a higher or lower tem ...
s, multiple sclerosis, headaches, dementia and movement disorders.


History

The academic discipline began between the 15th and 16th centuries with the work and research of many neurologists such as
Thomas Willis Thomas Willis FRS (27 January 1621 – 11 November 1675) was an English doctor who played an important part in the history of anatomy Anatomy (Greek ''anatomē'', 'dissection') is the branch of biology concerned with the study of the structu ...

Thomas Willis
,
Robert Whytt Dr Robert Whytt (1714–1766) was a Scottish physician. His work, on unconscious reflexes, tubercular meningitis, urinary bladder stones, and hysteria, is remembered now most for his book on diseases of the nervous system In Biology, biolog ...
,
Matthew Baillie Matthew Baillie (27 October 1761 – 23 September 1823) was a British physician and pathologist, credited with first identifying transposition of the great vessels (TGV) and situs inversus. Early life and education He was born in Shotts Manse ...

Matthew Baillie
,
Charles Bell Sir Charles Bell (12 November 177428 April 1842) was a Scottish Scottish usually refers to something of, from, or related to Scotland, including: *Scottish Gaelic, a Celtic Goidelic language of the Indo-European language family native to Scotla ...
, Moritz Heinrich Romberg,
Duchenne de Boulogne Guillaume-Benjamin-Amand Duchenne (de Boulogne) (September 17, 1806 in Boulogne-sur-Mer – September 15, 1875 in Paris) was a French neurologist who revived Luigi Galvani, Galvani's research and greatly advanced the science of electrophysiology. ...
, ,
Jean-Martin Charcot Jean-Martin Charcot (; 29 November 1825 – 16 August 1893) was a French neurologist Neurology (from el, νεῦρον (neûron), "string, nerve" and the suffix -logia, "study of") is a branch of medicine Medicine is the Art (skill), ...

Jean-Martin Charcot
, C. Miller Fisher and
John Hughlings Jackson John Hughlings Jackson, FRS FRS may also refer to: Government and politics * Facility Registry System, a centrally managed Environmental Protection Agency database that identifies places of environmental interest in the United States * Family R ...

John Hughlings Jackson
. Neo-Latin ''neurologia'' appeared in various texts from 1610 denoting an anatomical focus on the nerves (variably understood as vessels), and was most notably used by Willis, who preferred Greek νευρολογία.


Training

Many neurologists also have additional training or interest in one area of neurology, such as stroke, epilepsy, headache, neuromuscular disorders,
sleep medicine Sleep medicine is a medical specialty or subspecialty devoted to the diagnosis and therapy of sleep disturbances and sleep disorder, disorders. From the middle of the 20th century, research has provided increasing knowledge and answered many ...
, pain management, or
movement disorder Movement disorders are clinical syndromes with either an excess of movement or a paucity of voluntary and involuntary movements, unrelated to weakness or spasticity. Movement disorders are synonymous with basal ganglia or extrapyramidal diseases. ...
s. In the United States and Canada, neurologists are physicians who have completed a postgraduate training period known as
residency Residency may refer to: * Residency (domicile), the act of establishing or maintaining a residence in a given place ** Permanent residency, indefinite residence within a country despite not having citizenship Education * Residency (medicine), a ...
specializing in neurology after graduation from
medical school A medical school is a tertiary education Tertiary education, also referred to as third-level, third-stage or post-secondary education, is the education Education is the process of facilitating learning, or the acquisition of knowled ...
. This additional training period typically lasts four years, with the first year devoted to training in
internal medicine Internal medicine or general internal medicine (in Commonwealth of Nations, Commonwealth nations) is the medical specialty dealing with the prevention, diagnosis, and treatment of internal diseases. Physicians specializing in internal medicine are ...
. On average, neurologists complete a total of eight to ten years of training. This includes four years of medical school, four years of residency and an optional one to two years of fellowship. While neurologists may treat general neurologic conditions, some neurologists go on to receive additional training focusing on a particular subspecialty in the field of neurology. These training programs are called fellowships, and are one to two years in duration. Subspecialties include brain injury medicine,
clinical neurophysiology Clinical neurophysiology is a medical specialty that studies the central and peripheral nervous systems through the recording of bioelectrical activity, whether spontaneous or stimulated. It encompasses both research regarding the pathophysiology a ...
,
epilepsy Epilepsy is a group of non-communicable neurological disorder A neurological disorder is any disorder of the nervous system In Biology, biology, the nervous system is a Complex system, highly complex part of an animal that coordinates i ...

epilepsy
, neurodevelopmental disabilities,
neuromuscular medicine Neuromuscular medicine is subspecialty of neurology and physical medicine and rehabilitation, physiatry that focuses the diagnosis and treatment of neuromuscular diseases. The field encompasses issues related to both diagnosis and medical treatment ...
,
pain medicine Pain management, pain killer, pain medicine, pain control or algiatry, is a branch of medicine Medicine is the science Science () is a systematic enterprise that builds and organizes knowledge Knowledge is a familiarity, awarenes ...
,
sleep medicine Sleep medicine is a medical specialty or subspecialty devoted to the diagnosis and therapy of sleep disturbances and sleep disorder, disorders. From the middle of the 20th century, research has provided increasing knowledge and answered many ...
, neurocritical care, vascular neurology (stroke),
behavioral neurology Behavioral neurology is a subspecialty of neurology Neurology (from el, wiktionary:νεῦρον, νεῦρον (neûron), "string, nerve" and the suffix wiktionary:-logia, -logia, "study of") is a branch of specialty (medicine), medicine dea ...
, child neurology, headache, multiple sclerosis, neuroimaging, neurooncology, and neurorehabilitation. In Germany, a compulsory year of psychiatry must be done to complete a residency of neurology. In the United Kingdom and Ireland, neurology is a subspecialty of general (internal) medicine. After five years of medical school and two years as a Foundation Trainee, an aspiring neurologist must pass the examination for
Membership of the Royal College of Physicians Membership of the Royal Colleges of Physicians of the United Kingdom (MRCP(UK)) is a postgraduate medical diploma in the United Kingdom (UK). The examinations are run by the Federation of the Medical Royal Colleges – the Royal College of Phys ...
(or the Irish equivalent) and complete two years of core medical training before entering specialist training in neurology. Up to the 1960s, some intending to become neurologists would also spend two years working in psychiatric units before obtaining a diploma in psychological medicine. However, that was uncommon and, now that the MRCPsych takes three years to obtain, would no longer be practical. A period of research is essential, and obtaining a higher degree aids career progression. Many found it was eased after an attachment to the Institute of Neurology at Queen Square, London. Some neurologists enter the field of rehabilitation medicine (known as
physiatry Physical medicine and rehabilitation, also known as physiatry, is a branch of medicine Medicine is the Art (skill), art, science, and Praxis (process) , practice of caring for a patient and managing the diagnosis, prognosis, Preventive medic ...
in the US) to specialise in neurological rehabilitation, which may include stroke medicine, as well as traumatic brain injuries.


Physical examination

During a
neurological examination A neurological examination is the assessment of sensory neuron and motor neuron, motor responses, especially reflexes, to determine whether the nervous system is impaired. This typically includes a physical examination and a review of the patient's ...
, the neurologist reviews the patient's health history with special attention to the patient’s neurologic complaints. The patient then takes a neurological exam. Typically, the exam tests mental status, function of the
cranial nerves Cranial nerves are the nerve A nerve is an enclosed, cable-like bundle of fibers (called axon An axon (from Greek ἄξων ''áxōn'', axis), or nerve fiber (or nerve fibre: see American and British English spelling differences#-re, -er, ...
(including vision), strength, coordination, reflexes, sensation and gait. This information helps the neurologist determine whether the problem exists in the nervous system and the clinical localization. Localization of the pathology is the key process by which neurologists develop their differential diagnosis. Further tests may be needed to confirm a diagnosis and ultimately guide therapy and appropriate management.


Clinical tasks

Neurologists examine patients who are referred to them by other physicians in both the
inpatient A patient is any recipient of health care Health care, health-care, or healthcare is the maintenance or improvement of health via the preventive healthcare, prevention, diagnosis, therapy, treatment, recovery, or cure of disease, illness, injur ...
and
outpatient A patient is any recipient of health care Healthcare is the maintenance or improvement of health Health is a state of physical, mental and social well-being Well-being, also known as ''wellness'', ''prudential value'' or ''quality of l ...
settings. Neurologists begin their interactions with patients by taking a comprehensive
medical history The medical history, case history, or anamnesis (from Greek: ἀνά, ''aná'', "open", and μνήσις, ''mnesis'', "memory") of a patient A patient is any recipient of health care services that are performed by Health professional, healthc ...
, and then performing a
physical examination In a physical examination, medical examination, or clinical examination, a medical practitioner examines a patient A patient is any recipient of health care services that are performed by Health professional, healthcare professionals. The pati ...

physical examination
focusing on evaluating the nervous system. Components of the
neurological examination A neurological examination is the assessment of sensory neuron and motor neuron, motor responses, especially reflexes, to determine whether the nervous system is impaired. This typically includes a physical examination and a review of the patient's ...
include assessment of the patient's
cognitive functionCognitive skills, also called cognitive functions, cognitive abilities or cognitive capacities, are brain-based skills which are needed in acquisition of knowledge, manipulation of information, and reasoning. They have more to do with the mechanisms ...
,
cranial nerves Cranial nerves are the nerve A nerve is an enclosed, cable-like bundle of fibers (called axon An axon (from Greek ἄξων ''áxōn'', axis), or nerve fiber (or nerve fibre: see American and British English spelling differences#-re, -er, ...
, motor strength,
sensationSensation refers to the processing of sense Sense relates to any of the systems and corresponding organs involved in sensation, i.e. the physical process of responding to Stimulus (physiology), stimuli and providing data for perception. During sensa ...
,
reflexes In biology Biology is the natural science that studies life and living organisms, including their anatomy, physical structure, Biochemistry, chemical processes, Molecular biology, molecular interactions, Physiology, physiological mechanism ...

reflexes
,
coordination Coordination may refer to: * Coordination (linguistics) In linguistics, coordination is a complex syntactic In linguistics, syntax () is the set of rules, principles, and processes that govern the structure of Sentence (linguistics), sentence ...
, and
gait Gait is the pattern of movement Movement may refer to: Common uses * Movement (clockwork), the internal mechanism of a timepiece * Motion (physics), commonly referred to as movement Arts, entertainment, and media Literature * Movemen ...
. In some instances, neurologists may order additional
diagnostic tests A medical test is a medical procedure performed to detect, diagnose, or monitor diseases, disease processes, susceptibility, or to determine a course of treatment. Medical tests such as, physical and visual exams, diagnostic imaging, genetic ...
as part of the evaluation. Commonly employed tests in neurology include imaging studies such as
computed axial tomography A CT scan or computed tomography scan (formerly known as computed axial tomography or CAT scan) is a medical image, imaging Scientific technique, technique used in radiology to get detailed images of the body noninvasively for Diagnosis, diagnost ...
(CAT) scans,
magnetic resonance imaging Magnetic resonance imaging (MRI) is a medical imaging Medical imaging is the technique and process of imaging Imaging is the representation or reproduction of an object's form; especially a visual representation (i.e., the formation of a ...
(MRI), and
ultrasound Ultrasound is sound wave In physics Physics is the that studies , its , its and behavior through , and the related entities of and . "Physical science is that department of knowledge which relates to the order of nature, or, ...

ultrasound
of major blood vessels of the head and neck. Neurophysiologic studies, including
electroencephalography Electroencephalography (EEG) is a method to record an electrogram of the electrical activity on the scalp that has been shown to represent the macroscopic activity of the surface layer of the brain underneath. It is typically non-invasive, with ...
(EEG), needle
electromyography Electromyography (EMG) is a technique for evaluating and recording the electrical activity produced by skeletal muscles.Kamen, Gary. Electromyographic Kinesiology. In Robertson, DGE et al. Research Methods in Biomechanics. Champaign, IL: Human K ...
(EMG),
nerve conduction studies A nerve conduction study (NCS) is a medical diagnostic test commonly used to evaluate the function, especially the ability of electrical conduction Electrical resistivity (also called specific electrical resistance or volume resistivity) is a ...
(NCSs) and evoked potentials are also commonly ordered. Neurologists frequently perform
lumbar puncture Lumbar puncture (LP), also known as a spinal tap, is a medical procedure in which a needle is inserted into the spinal canal The spinal canal (or vertebral canal or spinal cavity) is the canal that contains the spinal cord The spinal cord ...
s to assess characteristics of a patient's
cerebrospinal fluid Cerebrospinal fluid (CSF) is a clear, colorless body fluid Body fluids, bodily fluids, or biofluids are liquid A liquid is a nearly incompressible In fluid mechanics or more generally continuum mechanics, incompressible flow (isochor ...
. Advances in
genetic testing Genetic testing, also known as DNA testing, is used to identify changes in DNA Deoxyribonucleic acid (; DNA) is a molecule File:Pentacene on Ni(111) STM.jpg, A scanning tunneling microscopy image of pentacene molecules, which consist o ...
have made genetic testing an important tool in the classification of inherited neuromuscular disease and diagnosis of many other neurogenetic diseases. The role of genetic influences on the development of acquired neurologic diseases is an active area of research. Some of the commonly encountered conditions treated by neurologists include headaches,
radiculopathy Radiculopathy, also commonly referred to as pinched nerve, refers to a set of conditions in which one or more nerve A nerve is an enclosed, cable-like bundle of fibers (called axon An axon (from Greek ἄξων ''áxōn'', axis), or nerve ...

radiculopathy
,
neuropathy Peripheral neuropathy, often shortened to neuropathy, is a general term describing disease affecting the peripheral nerve A nerve is an enclosed, cable-like bundle of fibers (called axon An axon (from Greek ἄξων ''áxōn'', axis), or n ...
, stroke,
dementia Dementia manifests as a set of related symptoms, which usually surface when the brain is damaged by injury or disease. The symptoms Signs and symptoms are the observed or detectable signs, and experienced symptoms of an illness, injury, or ...
,
seizure An epileptic seizure, formally known as a seizure, is a period of symptom Signs and symptoms are the observed or detectable signs, and experienced symptoms of an illness, injury, or condition. A sign for example may be a higher or lower tem ...
s and
epilepsy Epilepsy is a group of non-communicable neurological disorder A neurological disorder is any disorder of the nervous system In Biology, biology, the nervous system is a Complex system, highly complex part of an animal that coordinates i ...

epilepsy
,
Alzheimer's disease Alzheimer's disease (AD), also referred to simply as Alzheimer's, is a that usually starts slowly and progressively worsens. It is the cause of 60–70% of cases of . The most common early symptom is difficulty in . As the disease advance ...
,
attention deficit/hyperactivity disorder Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by inattention, or excessive activity and impulsivity, which are otherwise not Developmental psychology, appropriate for a person's age. Some indiv ...
,
Parkinson's disease Parkinson's disease (PD), or simply Parkinson's, is a chronic condition, long-term neurodegeneration, degenerative disorder of the central nervous system that mainly affects the motor system. The symptoms usually emerge slowly, and as the disea ...
,
Tourette's syndrome Tourette syndrome or Tourette's syndrome (abbreviated as TS or Tourette's) is a common neurodevelopmental disorder that begins in childhood or adolescence. It is characterized by multiple movement (motor) tics and at least one vocal (phonic) ...
,
multiple sclerosis Multiple sclerosis (MS), also known as encephalomyelitis disseminata, is the most common demyelinating disease, in which the Myelin, insulating covers of nerve cells in the Human brain, brain and spinal cord are damaged. This damage disrupts the ...
,
head trauma A head injury is any injury that results in trauma to the skull or brain. The terms ''traumatic brain injury'' and ''head injury'' are often used interchangeably in the medical literature. Because head injuries cover such a broad scope of injur ...
,
sleep disorder A sleep disorder, or somnipathy, is a medical disorder A disease is a particular abnormal condition that negatively affects the structure A structure is an arrangement and organization of interrelated elements in a material object or ...
s,
neuromuscular disease Neuromuscular disease is a broad term that encompasses many disease A disease is a particular abnormal condition that negatively affects the structure A structure is an arrangement and organization of interrelated elements in a materia ...
s, and various infections and tumors of the nervous system. Neurologists are also asked to evaluate unresponsive patients on
life support Life support refers to the treatments and techniques performed in an emergency in order to support life after the failure of one or more vital organs. Healthcare providers and emergency medical technician An emergency medical technician (EMT ...
to confirm
brain death Brain death is the complete loss of brain function A brain is an organ that serves as the center of the nervous system In Biology, biology, the nervous system is a Complex system, highly complex part of an animal that coordinates its B ...
. Treatment options vary depending on the neurological problem. They can include referring the patient to a , prescribing medications, or recommending a surgical procedure. Some neurologists specialize in certain parts of the nervous system or in specific procedures. For example, clinical neurophysiologists specialize in the use of EEG and
intraoperative monitoring Intraoperative neurophysiological monitoring (IONM) or intraoperative neuromonitoring is the use of clinical neurophysiology, electrophysiological methods such as electroencephalography (EEG), electromyography (EMG), and evoked potentials to monitor ...
to diagnose certain neurological disorders. Other neurologists specialize in the use of
electrodiagnostic medicine Electrodiagnosis (EDX) is a method of medical diagnosis Medical diagnosis (abbreviated Dx or DS) is the process of determining which disease or condition explains a person's symptoms and medical sign, signs. It is most often referred to as diagnos ...
studies – needle EMG and NCSs. In the US, physicians do not typically specialize in all the aspects of clinical neurophysiology – i.e. sleep, EEG, EMG, and NCSs. The American Board of Clinical Neurophysiology certifies US physicians in general clinical neurophysiology, epilepsy, and intraoperative monitoring. The American Board of Electrodiagnostic Medicine certifies US physicians in
electrodiagnostic medicine Electrodiagnosis (EDX) is a method of medical diagnosis Medical diagnosis (abbreviated Dx or DS) is the process of determining which disease or condition explains a person's symptoms and medical sign, signs. It is most often referred to as diagnos ...
and certifies technologists in nerve-conduction studies. Sleep medicine is a subspecialty field in the US under several medical specialties including
anesthesiology Anesthesiology is the medical specialty A medical specialty is a branch of medical practice that is focused on a defined group of patients, diseases, skills, or philosophy. Examples include children (paediatrics Pediatrics (American and Bri ...
,
internal medicine Internal medicine or general internal medicine (in Commonwealth of Nations, Commonwealth nations) is the medical specialty dealing with the prevention, diagnosis, and treatment of internal diseases. Physicians specializing in internal medicine are ...
,
family medicine Family medicine is a medical Specialty (medicine), specialty within primary care that provides continuing and comprehensive health care for the individual and family across all ages, genders, diseases, and parts of the body. The specialist, who i ...
, and neurology. Neurosurgery is a distinct specialty that involves a different training path, and emphasizes the surgical treatment of neurological disorders. Also, many nonmedical doctors, those with doctoral degrees (usually PhDs) in subjects such as biology and chemistry, study and research the nervous system. Working in laboratories in universities, hospitals, and private companies, these neuroscientists perform clinical and laboratory experiments and tests to learn more about the nervous system and find cures or new treatments for diseases and disorders. A great deal of overlap occurs between
neuroscience Neuroscience is the scientific study of the nervous system In biology, the classical doctrine of the nervous system determines that it is a Complex system, highly complex part of an animal that coordinates its Behavior, actions and Sens ...

neuroscience
and neurology. Many neurologists work in academic training hospitals, where they conduct research as neuroscientists in addition to treating patients and teaching neurology to
medical student A medical school is a tertiary educational institution, or part of such an institution, that teaches medicine, and awards a professional degree for physicians and surgeons. Such medical degrees include the Bachelor of Medicine, Bachelor of Surg ...

medical student
s.


General caseload

Neurologists are responsible for the diagnosis, treatment, and management of all the conditions mentioned above. When surgical or endovascular intervention is required, the neurologist may refer the patient to a
neurosurgeon Neurosurgery or neurological surgery, known in common parlance as brain surgery, is the medical specialty A medical specialty is a branch of medical practice that is focused on a defined group of patients, diseases, skills, or philosophy. Examp ...
or an interventional neuroradiologist. In some countries, additional legal responsibilities of a neurologist may include making a finding of brain death when it is suspected that a patient has died. Neurologists frequently care for people with hereditary () diseases when the major manifestations are neurological, as is frequently the case.
Lumbar puncture Lumbar puncture (LP), also known as a spinal tap, is a medical procedure in which a needle is inserted into the spinal canal The spinal canal (or vertebral canal or spinal cavity) is the canal that contains the spinal cord The spinal cord ...
s are frequently performed by
neurologists Neurology (from el, νεῦρον (neûron), "string, nerve" and the suffix -logia, "study of") is a branch of medicine Medicine is the Art (skill), art, science, and Praxis (process) , practice of caring for a patient and managing the d ...
. Some neurologists may develop an interest in particular subfields, such as stroke,
dementia Dementia manifests as a set of related symptoms, which usually surface when the brain is damaged by injury or disease. The symptoms Signs and symptoms are the observed or detectable signs, and experienced symptoms of an illness, injury, or ...
,
movement disorders Movement disorder refers to any clinical syndrome with either an excess of movement or a paucity of voluntary and involuntary movements, unrelated to weakness or spasticity Spasticity () is a feature of altered skeletal muscle Skeletal muscles ...
, neurointensive care, headaches,
epilepsy Epilepsy is a group of non-communicable neurological disorder A neurological disorder is any disorder of the nervous system In Biology, biology, the nervous system is a Complex system, highly complex part of an animal that coordinates i ...

epilepsy
,
sleep disorders A sleep disorder, or somnipathy, is a medical disorder of the sleep Sleep is a naturally recurring state of mind and body, characterized by altered consciousness , an English Paracelsian physician Consciousness, at its simplest, is "sent ...
, chronic
pain Pain is a distressing feeling often caused by intense or damaging stimuli. The International Association for the Study of Pain The International Association for the Study of Pain (IASP) is an international learned society A learned societ ...
management,
multiple sclerosis Multiple sclerosis (MS), also known as encephalomyelitis disseminata, is the most common demyelinating disease, in which the Myelin, insulating covers of nerve cells in the Human brain, brain and spinal cord are damaged. This damage disrupts the ...
, or
neuromuscular A neuromuscular junction (or myoneural junction) is a chemical synapse Chemical synapses are biological junctions through which neuron A neuron or nerve cell is an electrically excitable cell that communicates with other cells via spec ...

neuromuscular
diseases.


Overlapping areas

Some overlap also occurs with other specialties, varying from country to country and even within a local geographic area. Acute
head trauma A head injury is any injury that results in trauma to the skull or brain. The terms ''traumatic brain injury'' and ''head injury'' are often used interchangeably in the medical literature. Because head injuries cover such a broad scope of injur ...
is most often treated by neurosurgeons, whereas
sequelae A sequela (, ; usually used in the plural, sequelae ) is a pathological Pathology is the study of the causesCauses, or causality, is the relationship between one event and another. It may also refer to: * Causes (band), an indie band based in ...
of head trauma may be treated by neurologists or specialists in rehabilitation medicine. Although stroke cases have been traditionally managed by internal medicine or hospitalists, the emergence of vascular neurology and
interventional neuroradiology ''Interventional Neuroradiology'' is a bimonthly peer-reviewed Peer review is the evaluation of work by one or more people with similar competencies as the producers of the work ( peers). It functions as a form of self-regulation by qualified ...
has created a demand for stroke specialists. The establishment of
Joint Commission The Joint Commission is a United States-based nonprofit tax-exempt 501(c) A 501(c) organization is a nonprofit organization in the Law of the United States#Federal law, federal law of the United States according to Internal Revenue Code and is ...

Joint Commission
-certified stroke centers has increased the role of neurologists in stroke care in many primary, as well as tertiary, hospitals. Some cases of nervous system
infectious disease An infection is the invasion of an organism's body tissues by disease-causing agents, their multiplication, and the reaction of host A host is a person responsible for guests at an event or for providing hospitality during it. Host may ...
s are treated by infectious disease specialists. Most cases of headache are diagnosed and treated primarily by
general practitioner In the medical profession, a general practitioner (GP) is a medical doctor A physician (American English American English (AmE, AE, AmEng, USEng, en-US), sometimes called United States English or U.S. English, is the set of varietie ...
s, at least the less severe cases. Likewise, most cases of
sciatica Sciatica is pain Pain is a distressing feeling often caused by intense or damaging stimuli. The International Association for the Study of Pain The International Association for the Study of Pain (IASP) is an international learned society ...

sciatica
are treated by general practitioners, though they may be referred to neurologists or surgeons (neurosurgeons or
orthopedic surgeons Orthopaedic surgery or orthopaedics, is the branch of surgery concerned with conditions involving the musculoskeletal system. Orthopaedic surgeons use both surgical and nonsurgical means to treat musculoskeletal Physical trauma, trauma, spine dis ...
).
Sleep disorders A sleep disorder, or somnipathy, is a medical disorder of the sleep Sleep is a naturally recurring state of mind and body, characterized by altered consciousness , an English Paracelsian physician Consciousness, at its simplest, is "sent ...
are also treated by pulmonologists and
psychiatrists A psychiatrist is a physician A physician (American English), medical practitioner (English in the Commonwealth of Nations, Commonwealth English), medical doctor, or simply doctor, is a professional who practices medicine, which is concern ...
.
Cerebral palsy Cerebral palsy (CP) is a group of movement disorders Movement disorder refers to any clinical syndrome with either an excess of movement or a paucity of voluntary and involuntary movements, unrelated to weakness or spasticity Spasticity () is ...

Cerebral palsy
is initially treated by
pediatricians Paediatrics ( also spelled pediatrics or pædiatrics) is the branch of medicine Medicine is the science Science (from the Latin word ''scientia'', meaning "knowledge") is a systematic enterprise that Scientific method, builds and Taxono ...

pediatricians
, but care may be transferred to an adult neurologist after the patient reaches a certain age.
Physical medicine and rehabilitation Physical medicine and rehabilitation, also known as physiatry, is a branch of medicine Medicine is the Art (skill), art, science, and Praxis (process) , practice of caring for a patient and managing the diagnosis, prognosis, Preventive medic ...
physicians may treat patients with neuromuscular diseases with electrodiagnostic studies (needle EMG and nerve-conduction studies) and other diagnostic tools. In the United Kingdom and other countries, many of the conditions encountered by older patients such as movement disorders, including Parkinson's disease, stroke, dementia, or gait disorders, are managed predominantly by specialists in
geriatric medicine Geriatrics, or geriatric medicine, is a specialty that focuses on health care of elderly people. It aims to promote health by prevention (medical), preventing and treating diseases and disabilities in older adults. There is no set age at which pa ...
. Clinical neuropsychologists are often called upon to
evaluate Evaluation is a systematic determination of a subject's merit, worth and significance, using criteria governed by a set of Standardization, standards. It can assist an organization, program, design, project or any other intervention or initiative ...
brain-
behavior Behavior (American English American English (AmE, AE, AmEng, USEng, en-US), sometimes called United States English or U.S. English, is the set of variety (linguistics), varieties of the English language native to the United States. Cur ...
relationships for the purpose of assisting with
differential diagnosis In healthcare, a differential diagnosis (abbreviated DDx) is a method of analysis of a patient's history and physical examination to arrive at the correct diagnosis. It involves distinguishing a particular disease A disease is a particu ...
, planning
rehabilitation Rehabilitation or Rehab may refer to: Health * Rehabilitation (neuropsychology), therapy to regain or improve neurocognitive function that has been lost or diminished * Rehabilitation (wildlife), treatment of injured wildlife so they can be returne ...
strategies, documenting
cognitive Cognition () refers to "the mental action or process of acquiring knowledge and understanding through thought, experience, and the senses". It encompasses many aspects of intellectual function Intellectual functioning refers to the "general men ...

cognitive
strengths and weaknesses, and measuring change over time (e.g., for identifying abnormal
aging Ageing or aging (see spelling differences Despite the various English dialects Dialect The term dialect (from Latin , , from the Ancient Greek word , , "discourse", from , , "through" and , , "I speak") is used in two distinct ways ...

aging
or tracking the progression of a
dementia Dementia manifests as a set of related symptoms, which usually surface when the brain is damaged by injury or disease. The symptoms Signs and symptoms are the observed or detectable signs, and experienced symptoms of an illness, injury, or ...
)


Relationship to clinical neurophysiology

In some countries such as the United States and Germany,
neurologists Neurology (from el, νεῦρον (neûron), "string, nerve" and the suffix -logia, "study of") is a branch of medicine Medicine is the Art (skill), art, science, and Praxis (process) , practice of caring for a patient and managing the d ...
may subspecialize in
clinical neurophysiology Clinical neurophysiology is a medical specialty that studies the central and peripheral nervous systems through the recording of bioelectrical activity, whether spontaneous or stimulated. It encompasses both research regarding the pathophysiology a ...
, the field responsible for EEG and
intraoperative monitoring Intraoperative neurophysiological monitoring (IONM) or intraoperative neuromonitoring is the use of clinical neurophysiology, electrophysiological methods such as electroencephalography (EEG), electromyography (EMG), and evoked potentials to monitor ...
, or in electrodiagnostic medicine
nerve conduction studies A nerve conduction study (NCS) is a medical diagnostic test commonly used to evaluate the function, especially the ability of electrical conduction Electrical resistivity (also called specific electrical resistance or volume resistivity) is a ...
, EMG, and evoked potentials. In other countries, this is an autonomous
specialty Specialty or speciality may refer to: * Deed, a contract in law * Index of speciality, a geometrical invariant * Speciality (album), ''Speciality'' (album), an album by J-Pop singer Nami Tamaki * Specialty (medicine), a field within medicine * Speci ...
(e.g., United Kingdom, Sweden, Spain).


Overlap with psychiatry

In the past, prior to the advent of more advanced diagnostic techniques such as
MRI Magnetic resonance imaging (MRI) is a medical imaging Medical imaging is the technique and process of imaging Imaging is the representation or reproduction of an object's form; especially a visual representation (i.e., the formation of a ...

MRI
some neurologists have considered psychiatry and neurologic to overlap. Although
mental illness A mental disorder, also called a mental illness or psychiatric disorder, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. Such features may be persistent, relapsing In internal medici ...
es are believed by many to be neurological disorders affecting the central nervous system, traditionally they are classified separately, and treated by
psychiatrists A psychiatrist is a physician A physician (American English), medical practitioner (English in the Commonwealth of Nations, Commonwealth English), medical doctor, or simply doctor, is a professional who practices medicine, which is concern ...
. In a 2002 review article in the ''
American Journal of Psychiatry ''The American Journal of Psychiatry'' is a monthly peer-reviewed Peer review is the evaluation of work by one or more people with similar competencies as the producers of the work ( peers). It functions as a form of self-regulation by qualifi ...
'', Professor Joseph B. Martin, Dean of
Harvard Medical School Harvard Medical School (HMS) is the graduate medical school A medical school is a tertiary education Tertiary education, also referred to as third-level, third-stage or post-secondary education, is the education Education is the ...
and a neurologist by training, wrote, "the separation of the two categories is arbitrary, often influenced by beliefs rather than proven scientific observations. And the fact that the brain and mind are one makes the separation artificial anyway".
Neurological disorders A neurological disorder is any disorder of the nervous system In biology Biology is the natural science that studies life and living organisms, including their anatomy, physical structure, Biochemistry, chemical processes, Molecular ...
often have
psychiatric Psychiatry is the specialty (medicine), medical specialty devoted to the diagnosis, prevention, and treatment of mental disorders. These include various maladaptations related to mood, behaviour, cognition, and perceptions. See glossary of psyc ...
manifestations, such as poststroke depression, depression and
dementia Dementia manifests as a set of related symptoms, which usually surface when the brain is damaged by injury or disease. The symptoms Signs and symptoms are the observed or detectable signs, and experienced symptoms of an illness, injury, or ...
associated with
Parkinson's disease Parkinson's disease (PD), or simply Parkinson's, is a chronic condition, long-term neurodegeneration, degenerative disorder of the central nervous system that mainly affects the motor system. The symptoms usually emerge slowly, and as the disea ...
, mood and cognitive dysfunctions in Alzheimer's disease, and
Huntington disease Huntington's disease (HD), also known as Huntington's chorea, is a neurodegenerative disease A neurodegenerative disease is caused by the progressive loss of structure or function of neuron A neuron or nerve cell is an membrane potentia ...
, to name a few. Hence, the sharp distinction between neurology and psychiatry is not always on a biological basis. The dominance of
psychoanalytic theory Psychoanalytic theory is the theory A theory is a rational Rationality is the quality or state of being rational – that is, being based on or agreeable to reason Reason is the capacity of consciously making sense of things, applying log ...

psychoanalytic theory
in the first three-quarters of the 20th century has since then been largely replaced by a focus on pharmacology. Despite the shift to a medical
model In general, a model is an informative representation of an object, person or system. The term originally denoted the plans of a building in late 16th-century English, and derived via French and Italian ultimately from Latin ''modulus'', a measure. ...

model
, brain science has not advanced to a point where scientists or
clinicians A clinician is a health care Health care, health-care, or healthcare is the maintenance or improvement of health via the preventive healthcare, prevention, diagnosis, therapy, treatment, recovery, or cure of disease, illness, injury, and other di ...
can point to readily discernible pathological lesions or genetic abnormalities that in and of themselves serve as reliable or predictive
biomarkers A biomarker, or biological marker is a measurable indicator Indicator may refer to: Biology * Indicator (genus), ''Indicator'' (genus), a genus of birds in the honeyguide family * Environmental indicator of environmental health (pressures, cond ...
of a given mental disorder.


Neurological enhancement

The emerging field of neurological enhancement highlights the potential of therapies to improve such things as workplace efficacy, attention in school, and overall happiness in personal lives. However, this field has also given rise to questions about
neuroethics Neuroethics refers to two related fields of study: what the philosopher Adina Roskies has called the ethics of neuroscience, and the neuroscience of ethics. The ethics of neuroscience comprises the bulk of work in neuroethics. It concerns the ethic ...
and the
psychopharmacology drugs Psychopharmacology (from Ancient Greek, Greek grc, wiktionary:ψῡχή, ψῡχή, psȳkhē, breath, life, soul, label=none; grc, wiktionary:φάρμακον, φάρμακον, pharmakon, drug, label=none; and grc, wiktionary:-λογία, ...
of lifestyle drugs can have negative and positive effects on neurology because different types of drugs can depend on people and their lives heyanne l.dorsey


See also

* American Board of Psychiatry and Neurology * American Osteopathic Board of Neurology and Psychiatry * ''Developmental Neurorehabilitation'' * List of neurologists * List of women neuroscientists * Neuroepigenetics * Neurohospitalist, a physician interested in inpatient neurological care


References

{{Authority control Neurology,