
A neurological examination is the first step in determining whether a patient’s symptoms are related to a disorder of the nervous system. Conditions that may require a neurologist’s assessment include muscle weakness, movement disorders, tremors, coordination problems, dizziness, lightheadedness, headaches, other types of pain, and memory issues.
EMG is a well-established term for a neurophysiological test that assesses the function of muscle and nerve fibers. The test can determine where the damage is, what type of damage it is (the nerve fibers or the insulating sheath of the nerve may be damaged), how severe it is, and often what the chances of recovery are. It is used as an important aid in the diagnosis of many diseases and disorders, including carpal tunnel syndrome, nerve root damage in lumbosciatica, tingling or weakness in the extremities, polyneuropathies, motor neuron disease, and other neuromuscular diseases.
In a patient with memory, thinking or behavioral disorders (from mild cognitive impairment to dementia), the diagnosis is made by talking to the patient, and often a description of the caregiver is also needed. When treating a patient with impaired movement (e.g. Parkinsonism) or involuntary movement (e.g. tremors, tics), video recordings can be very helpful. The examination is followed by testing of mental abilities (the patient should bring glasses) and/or motor functions, and then a plan for confirming the diagnosis, treatment with medication and - together with the caregiver - also more comprehensive psychosocial treatment.
Dizziness when standing up or standing for a long time is a common problem in people of all ages, ranging from a barely noticeable discomfort to a severe disorder in which activity in an upright position is severely limited or there are frequent losses of consciousness and falls. In young people, the most common causes are so-called reflex or vasovagal syncope and orthostatic tachycardia syndrome (POTS), which can also be accompanied by poorer tolerance of physical exertion and severe fatigue. In the elderly, disorders of the autonomic nervous system, heart disease and the influence of medications are at the forefront, which makes it impossible to regulate blood pressure in an upright position and, among other things, can pose a risk of falls. With a detailed clinical examination and specific tests, in the vast majority of cases we can determine the cause of the problem and recommend effective treatment.
There are few people who do not have headaches at least occasionally. Sometimes, however, headaches become a factor that limits a person's activities or (in a minority of cases) are a harbinger of another illness. Consultation regarding headaches makes sense when they are frequent or very severe, so that they interfere with normal activities or the person often takes painkillers because of them. It also makes sense in cases of new, severe headaches, especially if they are accompanied by other problems (e.g. dizziness, nausea, weakness). A good reason is also if a person is worried about headaches or wants a more detailed consultation about them in order to avoid escalating the problems.
A carotid artery ultrasound is used to assess changes in the neck arteries that carry blood to the brain. The most common reason is detecting plaque buildup in the artery walls due to atherosclerosis. Less commonly, changes are found due to inflammation or injury. Narrowing of the artery, regardless of cause, increases the risk of blood clots, which in the case of carotid arteries can lead to a stroke. Ultrasound allows for early detection and timely intervention.
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