- What is a neurologist?
A neurologist is a medical specialist who treats disorders of the central nervous system (brain and spinal cord) and neuromuscular system (nerve and muscle).
- How should patients choose a neurologist?
The most efficient way to determine that your neurologist is up-to-date is to verify his board certification. Neurologists should be certified by the American Board of Psychiatry and Neurology. In addition to this general certification, physicians may have specific interests such as sleep medicine, vascular neurology (stroke medicine), epilepsy, to name a few. Board certification requires rigorous study and assures competence.
- What does a neurologist treat
This depends somewhat on the training and interests of the neurologist. All neurologists treat problems such as headaches (migraines and otherwise), seizures, dizziness, strokes, carpal tunnel syndrome, and neuropathy (often resulting in numbness/tingling in the extremities). Other common conditions cared for by sub-specialty neurologists include sleep-related problems.
- How prevalent are sleep disorders?
The most frequent sleep disorder that requires nighttime testing is obstructive sleep apnea which affects approximately 4% of the population. Much less common disorders such as narcolepsy may also require nighttime testing. However, conditions such as insomnia which generally do not require nighttime sleep testing are much more common with approximately 10% of the population experiencing chronic insomnia and about 30% of the population with intermittent insomnia. These patients can often benefit from the assistance of a board certified sleep specialist in cooperation with a psychologist specializing in treatment known as cognitive behavioral therapy for insomnia.
- What is sleep apnea?
The most common form of sleep apnea encountered in a practice is obstructive sleep apnea. In this condition, breathing is disrupted in sleep by collapse of the airway during inspiration. This results in a drop of blood oxygen, an increase in blood carbon dioxide, and is often complicated by conditions such as stroke, coronary artery disease, congestive heart failure, atrial fibrillation, and hypertension. Patients’ families report loud snoring with occasional interruptions in breathing. Patients typically report non-restful sleep with a poor energy level despite what they consider to be adequate nocturnal sleep.
- How is sleep apnea treated?
Obstructive sleep apnea is most commonly treated initially with CPAP (Continuous Positive Airway Pressure). In selected patients, most notably patients with relatively mild apnea or positional apnea (less prominent when not lying on back), a dental orthosis (mouth piece called a mandibular advancement device) may be helpful. There are surgical procedures that may be beneficial in carefully selected patients.
- How has the neurology field evolved?
The most notable advances in neurology over the past decade have been in the field of imaging such as magnetic response imaging (MRI) and genetics. It is increasingly important that neurologists remain up-to-date with these advances when directing a workup. For example, the protocol for performing an MRI of the brain varies depending on the problem (i.e., different views are needed in MS or vertigo than in seizures). This direction can streamline patient evaluation and help to hold down costs.
- What can patients expect when they visit a neurologist?
Patients should expect a physician who listens to their medical history and pays attention to their concerns. If diagnostic testing is suggested, the neurologist should explain why it is needed in understandable terms. Treatment options should also be explained with the goal of helping the patient participate in treating their neurological condition.