SAIFEE HOSPITAL

under the auspices of Saifee Hospital Trust Reg no. E-5448 (Bom)

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Neurology

Neurology is the medical specialty that deals with the diagnosis and treatment of all categories of disease involving the central, peripheral, and autonomous nervous systems, including their coverings, blood vessels, and all effector tissues, such as muscles.

Neurological disorders are disorders those that affect the central nervous system (brain and spinal cord), the peripheral nervous system, or the autonomous nervous system.

Major conditions include:

• Behavioral/cognitive syndromes

• Headache disorders such as migraine, cluster headache and tension headache

• Seizure disorders

• Neurodegenerative disorders, including Alzheimer's disease, Parkinson's disease, Huntington's
disease, and Amyotrophic lateral sclerosis (Lou Gehrig's disease).

• Cerebrovascular disease, such as transient ischemic attack and stroke.

• Sleep disorders

• Cerebral palsy

• Infections of the brain (encephalitis), brain meninges (meningitis), spinal cord (myelitis)

• Infections of the peripheral nervous system

• Neoplasms - tumors of the brain and its meninges (brain tumors), spinal cord tumors, tumors of the peripheral nerves (neuroma)

• Movement disorders such as Parkinson's disease, Huntington's disease, hemiballismus, tic disorder, and Gilles de la Tourette syndrome

• Demyelinating diseases of the central nervous system, such as multiple sclerosis, and of the peripheral nervous system, such as Guillain-Barrι syndrome and chronic inflammatory demyelinating polyneuropathy (CIDP)

• Spinal cord disorders - tumors, infections, trauma, malformations (e.g., myelocele, meningomyelocele, tethered cord)

• Disorders of peripheral nerves, muscle (myopathy) and neuromuscular junctions

• Traumatic injuries to the brain, spinal cord and peripheral nerves

• Altered mental status, encephalopathy, stupor and coma

• Speech and language disorders

Neurologists also care for people with hereditary (genetic) diseases when the major manifestations are neurological, as is the case frequently. Lumbar punctures are frequently performed by neurologists. Some neurologists may specialise in particular subfields, such as dementia, movement disorders, headaches, epilepsy, sleep disorders, chronic pain management, multiple sclerosis or neuromuscular diseases.

Associated Diagnostic Procedures:

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 if the problem exists in the nervous system and the clinical localization. Further tests may be needed to confirm a diagnosis and ultimately guide therapy and appropriate management.

Neurologists are responsible for the diagnosis, treatment, and management of all the above conditions. When surgical intervention is required, the neurologist may refer the patient to a neurosurgeon, an interventional neuroradiologist, or a neurointerventionalist.

Neuro Surgery

Neurological Surgery is the specialty of surgery which provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomous nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes that modify the function or activity of the nervous system, including the hypophysis: and the operative and nonoperative management of pain.

As such, neurological surgery encompasses the surgical, nonsurgical and stereotactic radiosurgical treatment of adult and pediatric patients with disorders of the nervous system: disorders of the brain, meninges, skull base, and their blood supply, including the surgical and endovascular treatment of disorders of the intracranial and extracranial vasculature supplying the brain and spinal cord; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those that may require treatment by heat fixation, instrumentation,or mendovascular techniques; and disorders of the cranial and spinal nerves throughout their distribution.

Neurosurgical conditions include primarily brain, spinal cord, vertebral column and peripheral nerve disorders.

Conditions treated by neurosurgeons include:

• Spinal disc herniation.

• Spinal stenosis.

• Hydrocephalus.

• Head trauma (brain hemorrhages, skull fractures, etc.)

• Spinal cord trauma.

• Traumatic injuries of peripheral nerves.

• Brain tumors.

• Infections and infestations.

• Tumors of the spine, spinal cord and peripheral nerves.

• Cerebral aneurysms.

• Some forms of hemorrhagic stroke, such as subarachnoid hemorrhages, as well as
intraparenchymal and intraventricular hemorrhages.

• Some forms of pharmacologically resistant epilepsy.

• Some forms of movement disorders (advanced Parkinson's disease, chorea) - this involves the use of specially developed minimally invasive stereotactic techniques (functional, stereotactic neurosurgery)

• Intractable pain of cancer or trauma patients and cranial/peripheral nerve pain.

• Some forms of intractable psychiatric disorders.

• Malformations of the nervous system.

• Carotid artery stenosis.

• Vascular malformations (i.e., arteriovenous malformations, venous angiomas, cavernous angiomas, capillary telangectasias) of the brain and spinal cord.

• Peripheral neuropathies such as Carpal Tunnel Syndrome and ulnar neuropathy.

• Moyamoya disease.

• Congenital malformations of the nervous system, including spina bifida and craniosynostosis.

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