Do neurologists perform surgery?

Neurology deals comprehensively with medical care for the neurological patient, teaching in all matters affecting the nervous system and research, both clinical and basic, within its scope.

Of all the body’s systems, damage to the nervous system can be possibly the most devastating. And although the inner workings of the nervous system are complex and involved, neurologists have dedicated their lives to understanding it.

In this brief guide, we’re going to answer the question “‘’Do neurologists perform surgery?’’ the basic concepts about neurology and surgery in the field of neurologists.

Do neurologists perform surgery?

No, Neurologists don’t perform surgery but may refer patients who require surgery to a neurosurgeon or spinal surgeon. In the case of surgery, a neurologist may continue to monitor and supervise treatment.

Neurologists are the primary care providers when a patient has a neurological disorder that requires frequent care. Neurologists often assume a consulting role for primary care physicians in the event of a stroke, concussion, or headache.

What’s a neurologist?

A neurologist is a medical doctor that specializes in the study, diagnosis, treatment, and management of injuries, diseases, and disorders of the nervous system. 

The nervous system includes the brain and spinal cord and is made up of two parts: the central and peripheral nervous system. Illnesses, disorders, and injuries that affect the nervous system often require a neurologist’s treatment.

The neurologist diagnoses and treats disorders of the brain, spinal cord, nerves, muscles, and pain, especially headache. Likewise, the neurologist deals with complications in the nervous system of many other diseases such as high blood pressure, diabetes, some traumas, tumors.

What conditions do neurologists treat?

Disorders

A neurologist treats disorders of the central and peripheral nervous system, including the brain, spinal cord, cranial nerves, peripheral nerves, nerve roots, autonomic nervous system, neuromuscular junction, and muscles.

Common disorders of the nervous system include:

• Epilepsy: A neurological disorder associated with abnormal electrical activity in the brain, causing recurrent, unprovoked seizures, and loss of consciousness.
• Alzheimer’s disease: Progressive mental deterioration that is caused by generalized degeneration of the brain.
• Stroke: A stroke occurs when a blood vessel is prevented from delivering oxygen and nutrients to the brain, due to a blood clot or rupture.
• Migraine: A severe, recurring headache often paired with nausea and disturbed vision.
•  Multiple Sclerosis: A chronic disease involving damage to nerve cells in the brain and spinal cord characterized by numbness, speech and muscular impairment, blurred vision, and severe fatigue.
• Parkinson’s disease: A progressive disease marked by tremor, muscular rigidity, and slow, imprecise movement. It’s associated with degeneration of the basal ganglia of the brain and dopamine deficiency.
• Brain tumors: A mass of abnormal cells in the brain, leading to impaired cognitive function.
•  Brain trauma: Injury to the brain from an outside force, sometimes leading to an altered state of consciousness, and permanent or temporary impairment of cognitive, physical, or psychosocial functions.
• Tourette’s Syndrome: A neurological disorder, coupled with involuntary tics and vocalizations, as well as the compulsive exclamation of obscenities.
•  Amyotrophic Lateral Sclerosis: A progressive deterioration of the motor neurons of the central nervous system, leading to muscular atrophy and paralysis.

Diseases

A Neurologist will treat diseases that attack the nervous system, such as:

•  Infections (bacterial, viral, fungal)
• Cancers (malignant, benign)

Neurological diseases and disorders are common, and the risk of developing one increases with age. Neurologic disorders, such as injury of the nervous system, are also a common occurrence. Research shows that as many as 60 million people worldwide may suffer a traumatic brain injury each year. It’s important to know the signs of neurological diseases and disorders, as they are serious and may be life-threatening when left untreated.

What are the functions of the neurologist?

The main objective of the neurologist is to optimize the medical, neurological, and behavioral state of the patient.

When the patient is admitted, the neurologist is in charge of initially evaluating the patient, his or her history, and current situation:

• Initial evaluation of the patient: Through the neurological examination, the place of the injury can be determined to help direct the most appropriate treatment.  The physical, neurological, cognitive, and behavioral deficits that will impair the patient’s functional recovery, as well as the ability to perform specific tasks, are also identified.
• Personal history: The neurologist must know the diseases before admission, that is, the medical comorbidities that must be treated. Specifically, high blood pressure, dyslipidemia, diabetes, and heart problems.
• Assessment of the patient’s current situation: To prevent complications derived from medication, previous illnesses, and brain damage. For example, epileptic seizures, infections (respiratory and urinary), dehydration, syncope, etc.

Neurosurgery vs Neurology?

Neurosurgery and neurology are specialties that are often confused with each other since both disciplines focus on the diagnosis and treatment of problems affecting the nervous system.

The difference between neurosurgery and neurology lies in the technique that each one uses for the treatment of these diseases.

A neurologist treats diseases and conditions of the brain and nervous system, but they don’t perform surgery. Some of the common conditions they treat include headaches, Alzheimer’s disease, multiple sclerosis, sleep disorders, pain, brain tumors, peripheral nerve disorders, and amyotrophic lateral sclerosis (ALS). Some neurologists focus on a subspecialty like neurophysiology, pediatric neurology, epilepsy, vascular neurology, behavioral neurology, or others.   

A neurologist can prescribe drugs, physical therapy, and advise on what habits to take to improve the quality of life. A neurosurgeon can do this and also perform surgery if the patient requires it.

Thus, if a person goes to a neurologist due to some head or spinal discomfort and the doctor detects that surgery is necessary, the patient will have to be referred to a neurosurgeon.

Neurosurgery, one common myth is that neurosurgeons are just brain surgeons. However, according to the American Association of Neurological Surgeons (AANS), they typically spend a lot more time on spine conditions and procedures than brain conditions and procedures.

Common conditions neurosurgeons treat are back pain, neck pain, sciatica, herniated disks, degenerative diseases of the spine, cerebrovascular disorders, brain and spinal tumors, and stroke.

Since the nervous system extends from your brain to your spine and your nerves branch out into your entire body, they treat conditions that present symptoms in one part of your body that are actually related to a problem in the central nervous system. For example, carpal tunnel symptoms are sometimes related to a problem in your cervical spine (neck area).

Although they can perform very complex surgeries, neurosurgeons typically use non-operative treatment plans before performing surgery. If surgery is required, minimally invasive techniques are used whenever possible. Neurosurgeons are also on call for emergency room physicians when a patient has trauma involving the brain and spinal cord.

Where to study neurology?

The US News releases their Best Global Universities Rankings annually. They use many criteria to rank universities and colleges, but some of the most important is the global and regional research reputation, the number of publications, the total number of cited works/papers, and international collaboration.

The best universities to study neurology are:

•  Harvard University.
• Stanford University.
• Massachusetts Institute of Technology (MIT).
• The University of California – San Francisco.
• Johns Hopkins University.
• Columbia University.
• The University of Pennsylvania.
• Washington University in St. Louis.
• University of California, San Diego.
• The University of California, Los Angeles (UCLA).

View the full neuroscience ranking on the U.S. News website.

What procedures do neurologists perform?

Lumbar Puncture

A lumbar puncture (also known as a spinal tap), is a procedure used to collect and examine the fluid surrounding the brain and the spinal cord. A needle is carefully inserted into the spinal canal in the lumbar area to collect cerebrospinal fluid (CSF).

Lumbar punctures are performed to find the cause of infections, inflammation, cancer or bleeding around the area surrounding the spinal cord or brain. 

It can also be used to diagnose certain diseases of the brain and spinal cord as well as deliver medications to the CSF. Lumbar punctures are also used to deliver a dye to the CSF to make the spinal cord and CSF more visible on X-rays (myelogram).

Electromyography

Electromyography (EMG) is a technique designed to evaluate and record the electrical activity of muscles. The test measures how well and how fast nerves can send electrical signals. 

It’s performed using an instrument called an electromyograph, which produces a record known as an electromyogram. Measuring the electrical activity in nerves and muscles can help uncover diseases such as muscular dystrophy and amyotrophic lateral sclerosis (ALS).

Tensilon Test

Tensilon is a trading name for edrophonium chloride, which is given intravenously. Tensilon blocks the action of acetylcholinesterase, an important neurotransmitter, and helps prolong muscle stimulation. An increase in muscle strength during the test can be an indicator of myasthenia gravis or a similar neurological condition.

Electroencephalogram

An electroencephalogram (EEG) is a test that measures and records the electrical activity of the brain. During the test, electrical sensors are attached to the head of the patient and run by wires to a computer. The computer then records the brain’s electrical activity which can be seen on-screen or printed on paper.

Sleep Study

Patients who have chronic sleep problems are diagnosed in a Sleep Study, also known as a Polysomnogram (PSG). During a Sleep Study the patient is monitored during sleep and physiological data is electronically recorded. This data is carefully analyzed by a neurologist later. The test is usually performed in a Sleep Lab.

So, do neurologists perform surgery?

Neurology is the medical specialty that studies the structure, function, and development of the nervous system (central, peripheral, and autonomic) and muscle in normal and pathological states, using all clinical and instrumental techniques of study, diagnosis, and treatment currently in use or that may be developed in the future.

Neurologists are specialists in preventing, diagnosing, treating, and rehabilitating without surgery, conditions that affect the nervous system (brain, skull, and spine). For example migraine, Parkinson’s disease, insomnia, memory loss, excessive stress, neuralgia, and so on.

Neurology deals comprehensively with the medical care of the neurological patient, teaching in all matters affecting the nervous system and research, both clinical and basic, within its scope.  On the other hand, the medical specialty that is in charge of performing surgeries is medical neurosurgeons who focus on the treatment of nerve diseases that may require surgery.

FAQSs: Do neurologists perform surgery?

Yes, the range of sleep disorders neurologists treat is wide and includes insomnia, sleep apnea, restless legs syndrome, and narcolepsy.

How does a neurologist check for nerve damage?

In this guide we answered the question “Do neurologists perform surgery?” and the most common questions about whether neurologists treat the nervous system and whether they are the same as neurosurgeons.

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References

Common Procedures Performed by Your Neurologist – Reliant Medical Group. (2014). Retrieved October 3, 2020, from Reliant Medical Group website: https://reliantmedicalgroup.org/medical-services/neurology/common-procedures/

Evaluation and Tests – What is a Neurological Exam? (2020). Retrieved October 3, 2020, from Uchicago.edu website: http://peripheralneuropathycenter.uchicago.edu/learnaboutpn/evaluation/neuroexam/index.shtml

Illiades, C. (2019, June 27). 8 Reasons to See a Neurologist. Retrieved October 3, 2020, from Healthgrades website: https://www.healthgrades.com/right-care/brain-and-nerves/8-reasons-to-see-a-neurologist

What conditions do neurologists treat | WWMG. (2016, September 6). Retrieved October 3, 2020, from Western Washington Medical Group website: https://www.wwmedgroup.com/blog/conditions-neurologists-treat/

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