Specialty physician who is qualified in the diagnosis and medical management of diseases of the nervous system (brain, spinal cord, peripheral nerves, and muscles).
During a neurological examination, the neurologist reviews the patient's health history with special attention to the current condition. The patient then takes a neurological exam. Typically, the exam tests mental status, function of the cranial nerves (including vision), strength, coordination, reflexes, and sensation. 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.
Neurologists examine patients who have been referred to them by other physicians in both the inpatient and outpatient settings. A neurologist will begin their interaction with a patient by taking a comprehensive medical history, and then perform a physical examination focusing on evaluating the nervous system. Components of the neurological examinationinclude assessment of the patient's cognitive function, cranial nerves, motor strength, sensation, reflexes, coordination, and gait.
In some instances, neurologists may order additional diagnostic tests as part of the evaluation. Commonly employed tests in neurology include imaging studies such ascomputed axial tomography (CAT) scans, magnetic resonance imaging (MRI), and ultrasound of major blood vessels of the head and neck. Neurophysiologic studies, including electroencephalography (EEG), needle electromyography (EMG), nerve conduction studies (NCSs) and evoked potentials are also commonly ordered. Neurologists frequently perform lumbar punctures in order to assess characteristics of a patient's cerebrospinal fluid. Advances in genetic testing has made genetic testing an important tool in the classification of inherited neuromuscular disease. The role of genetic influences on the development of acquired neuromuscular diseases is an active area of research.
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