When You Need A Neurologist

CONSIDER these real-life situations:

Case one:

A previously-well 26-year-old woman is admitted to hospital after experiencing seizures. She had episodes of loss of consciousness associated with limb-jerking movements.  One side of her body also became paralysed.

A brain scan revealed a blood clot in a major vein of her brain. After appropriate blood-thinning medication, the clot cleared and her condition gradually improved back to normal.

Case Two:

A fit 35-year-old man suddenly has headaches, neck stiffness and fever that started a day ago. He is confused and agitated by the time he is brought to hospital several hours later by his family.

The doctors wasted no time in getting him started on powerful antibiotics via an intravenous drip. A spinal tap confirms that he has a bacterial infection of the brain. A right choice of antibiotics is selected and he recovers quickly and returns back to his normal life.

Case Three: A 48-year-old man with long-standing Parkinson’s disease finds it even harder to move his “frozen body”. This is because each dose of his medication now lasts only two hours, instead of providing a smooth benefit throughout the day (as it did in the early years of his illness).

During these “off” periods, he is completely unable to walk because his feet are “glued” to the floor. When he needs to go to the toilet, he has to literally crawl to get there.

A special surgery on his brain, however, markedly improves his condition within a few months. It was such a success so much so that he is now looking forward to being able to work again.

“Without prompt neurologic diagnosis and treatment, the first two patients would likely have suffered permanent brain damage, or even died,” says Dr. Lim Shen-Yang, who serves as a consultant neurologist at the University Hospital (PPUM) in Kuala Lumpur.

In an interview with Wheel Power this week, Dr Lim who studied at world-renowned institutions overseas, including obtaining a Toronto Fellowship in movement disorders and deep brain stimulation, points out that despite the critical role that neurologists play in the lives of people, most people still don’t know what they do.

“As neurologists, we face many challenges on a day-to-day basis,” he says and went on to explain what a neurologist is.

We are doctors who specialize in diagnosing and treating disorders of the nervous system, which includes the brain, spinal cord, nerves, and muscles.

Our job is to care for patients with neurologic disorders that are treated primarily with medicines.

“Although there is obviously going to be some overlap in what we do, this is in contrast to neurosurgery where neurosurgeons are specialists who perform surgeries for neurologic disorders like removal of brain tumours, for instance,” explains Dr Lim who has authored numerous publications in prestigious medical journals and books and also serves as an associate editor of Neurology Asia.

The same distinction, he adds, applies to cardiologists or “physicians” who treat heart conditions primarily with medicines, although many now also perform “minimally-invasive” procedures such as angioplasties or “balloons” vs. heart surgeons, and gastroenterologists vs. abdominal surgeons. 

Dr Lim who spent 16 years in medical training until he became a specialist in neurology points out that neurologic disorders are more common than what many people tend to believe. 

“Just think about the people who are affected by Alzheimer’s dementia, Parkinson’s disease, stroke, epilepsy, migraine and others,” he says.

“People of all ages and backgrounds can be affected. Nobody is immune.

“Furthermore, as society becomes more affluent and life-spans increase, age-related or ‘degenerative’ conditions such as dementia and Parkinson’s become increasingly common.”

In the first two cases cited above, Dr Lim points out that a good outcome was possible because of several critical reasons.

First was because the patients themselves or through the help of their family members sought appropriate medical consultation early.

The second was because neurologic diagnosis was accurate and the treatment given to them was rapid.

“Had there been a significant delay in the institution of appropriate treatment – something that sadly is still a very common occurrence today – permanent brain damage would likely have occurred.

“The third patient’s problem could not be considered ‘life-or-death’; however, proper and timely treatment again led to a profound and life-changing improvement in his (and his family’s) quality of life.

“It is important for all of us to remember that the treatment options for a wide variety of neurologic conditions have improved greatly over the last several decades.” 

(For more information on today’s topic, Dr. Lim can be reached by email: limshenyang@ymail.com)

The End

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