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Neurology & Stroke

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At Cape Cod Healthcare, you’ll find expert care for a wide range of complex and chronic conditionsNeurologic Services & Treatments.

What is a Neurologist?

A neurologist is a medical doctor with specialized training in diagnosing and treating disorders of the brain and nervous system (spinal cord, nerves and muscles).  Neurologists do not perform surgery, rather they treat a variety of neurological disorders with medications and counseling.   Brain and spinal surgeries are completed by neurosurgeons.  A neurologist completes an undergraduate degree, four years of medical school, a one-year medical internship and at least three years of specialized neurology training.  Many neurologists spend an additional year with additional training in specific neurology subspecialties.  Many of our neurologists completed a fellowship treating nerve and muscle (“neuromuscular”) diseases and specialized electromyography (EMG) testing, a test to diagnose a variety of nerve and muscle diseases.

What are common conditions which a neurologist treats?

Common neurologic disorders which a neurologist treats in older patients include:

Common neurologic disorders which neurologists treat in younger patients include:

What is the difference between a DO and an MD?

A doctor of osteopathic medicine (D.O.) is a fully trained and licensed doctor who graduated from an osteopathic medical school in the United States.  A doctor of medicine (M.D.) has graduated from a conventional (allopathic) medical school. The major difference between osteopathic and allopathic doctors is that osteopathic doctors receive additional training in manual medical therapies, such as spinal manipulation, as an additional treatment. 

Upon graduation from either medical school, both D.O and M.D. physicians complete the same medical internships and residencies together in their chosen specialty or primary care.  Both D.O.'s and M.D.’s must pass the same national licensing examination before they can treat patients.

What is the difference between a neurologist and neurosurgeon?

A neurologist is a physician who specializes in the diagnosis and medical treatment of a variety of neurological conditions affecting the brain, spinal cord, nerves and muscles.  A neurologist treats these various conditions with medications and counseling.  They may recommend surgical treatment when indicated at which point their patient will be referred to a Neurosurgeon.

A Neurosurgeon is a physician who specializes in the diagnosis and surgical treatment of disorders of the brain and spinal cord.

What can I expect at my first neurology consultation?

A nurse or medical assistant with specialized training caring for patients with neurological diseases will lead you to your exam room and take a detailed history including your:

  • Past medical and surgical history
  • Current medication list: prescription and over-the-counter medications and vitamins / herbal supplements including name, current dose and frequency
  • Medication allergies
  • Details of family history
  • Social history including your current living situation, degree of alcohol and tobacco use

Your neurologist will then take a detailed history including your presenting complaint and current symptoms.  Keeping a list or notebook detailing your complaints along with questions to bring to your appointment can be helpful.  It is often helpful to have a family member or friend with you at your appointment to listen and take notes, in particular if you are being evaluated for memory difficulties.

Your neurologist will then perform a detailed exam including assessment of: memory and speech, strength, sensation, coordination, walking and deep tendon reflexes.  Upon completion of the history and physical exam, your neurologist will discuss possible diagnoses to explain your complaint(s) and order any needed diagnostic testing to aid in an accurate diagnosis.   Your neurologist may also prescribe medications if indicated for treatment of your symptoms.

What are the common diagnostic tests your neurologist may recommend?

What is an EMG?

An Electromyogram (EMG) Test diagnoses abnormalities of nerves and muscles.  It is commonly completed to assess for: a pinched nerve in the neck or back, peripheral neuropathy and a variety of other nerve syndromes (carpal tunnel syndrome, foot drop, among others) and muscle disorders.  All of the testing will be completed by a board-certified Neurologist.  An hour is scheduled for the appointment, however the EMG testing is typically shorter.  There are two parts of this test, the Nerve Conduction Studies and Needle EMG Exam.

Nerve Conduction Studies:

This test will take 10 – 30 minutes depending on the number of limbs which must be tested.  You will feel a small shock within the hands and feet while the machine records your nerve function.  This shock sensation tends to be more annoying than painful.

Needle EMG Exam:

This test will take 5 – 15 minutes depending on the number of limbs which must be tested.  A very small needle, the width of an acupuncture needle, will be inserted into a few muscles of the arm or leg, one at a time.  This needle is a microphone so we can record your muscle electricity, similar to recording at your heart muscle electricity during an EKG(electrocardiogram).  There are no shocks or material injected through the needle.  You will feel a small pinch as it enters the skin.  Occasionally, there is some mild muscle cramping when you are asked by the doctor to contract that muscle.

After the Test:

The doctor will discuss the preliminary results with you.  You may take all of your medications routinely before and afterwards, no medications need to be held for this test.  Please tell the neurologist if you take any blood-thinner medications (Coumadin, Xarelto, Pradaxa, Eliquis)

What do I need to do prior to EMG testing?

Eat your regular breakfast or lunch before the EMG, you do not have to be fasting for this test. Take a bath or shower on the day of your EMG. Do not rub lotion, oil or cream onto your skin.

Wear loose-fitting and comfortable clothing to your EMG.  You may be asked to change into a hospital gown, however you may leave all your undergarments on.

Bring a list of your medications to your EMG appointment.  It is safe to take your medications as scheduled prior to EMG testing.  Do not stop taking any of your medicines prior to EMG testing. Tell your doctor if you are taking an anticoagulant (blood thinner) medicine or have a bleeding disease.

Avoid smoking or having caffeinated food and drinks for three hours before the EMG. Caffeine may be found in coffee, tea, soda, sports drinks and certain foods.

Tell your doctor if you have a cardiac pacemaker or defibrillator.  If so, it is safe for you to complete EMG testing and the results will not be affected.

What is Neuropsychological testing?

Neuropsychological testing is a series of tests given by a clinical neuropsychologist to help clarify a diagnosis when a patient is having cognitive issues such as memory difficulties. Testing typically takes 2-4 hours and may be broken up over 2 days. The patient may be asked to bring a close friend or family member with them to the testing in order to provide further information about the patient’s symptoms and any recent progression. Once the testing is completed, a final report is sent to the ordering neurologist within 2-4 weeks. The neuropsychologist will review the results with the patient afterwards. Your neurologist will review the results and recommendations again with the patient at your next  neurology follow up appointment.

Continuum of Care

You can count on us for comprehensive care, from diagnosis and treatment through long-term follow-up. Our team of neurologists, neurosurgeons, nurses, psychiatrists and social workers works with you and your primary care physician to manage your condition and meet all your healthcare needs.

You have access to a wide range of rehabilitation services to help you recover skills and maximize your quality of life. We also coordinate home care, if needed, with the Visiting Nurse Association of Cape Cod, part of Cape Cod Healthcare.

Contact Us

For more information or for help finding a physician, call our Access Line at 877-CAPECOD or email us today.

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