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'''Neurology''' is a [[medical]] speciality dealing with disorders of the nervous system.  Specifically, it deals with the diagnosis and treatment of all categories of disease involving the [[Central nervous system|central]], [[Peripheral nervous system|peripheral]], and [[autonomic nervous system|autonomic nervous systems]], including their coverings, blood vessels, and
all effector tissue, such as muscle.<ref>http://www.acgme.org/acWebsite/downloads/RRC_progReq/180neurology07012007.pdf</ref> [[Physicians]] who specialize in neurology are called '''neurologists''', and are trained to investigate, or diagnose and treat, neurological disorders. Pediatric neurologists treat neurological disease in children. Neurologists may also be involved in [[clinical research]], [[clinical trials]], as well as [[basic research]] and [[translational research]]. In the United Kingdom, contributions to the field of Neurology stem from various professions; saliently, several biomedical research scientists are choosing to specialise in the technical/laboratory aspects of one of neurology's subdisciplines.

==Field of work==
'''Neurological disorders''' are disorders that affect the [[central nervous system]] ([[brain]] and [[spinal cord]]), the [[peripheral nervous system]], or the [[autonomic nervous system]].

Major conditions include:
* [[Behavioral neurology|Behavioral/cognitive syndromes]]
* [[Headache|Headache disorders]] such as [[migraine]], [[cluster headache]] and [[tension headache]] 
* [[Seizure|Seizure]] disorders
* [[Neurodegenerative disorder|Neurodegenerative disorders]], including [[Alzheimer's disease]], [[Parkinson's disease]], [[Huntington's disease]], and [[Amyotrophic lateral sclerosis]] ([[Amyotrophic lateral sclerosis|Lou Gehrig's disease]]). 
* Cerebrovascular disease, such as [[transient ischemic attack]] and [[stroke]].
* [[Sleep disorder|Sleep disorders]]
* [[Cerebral palsy|Cerebral palsy]] 
* [[Infection|Infections]] of the brain ([[encephalitis]]), brain meninges ([[meningitis]]), spinal cord ([[myelitis]])
* [[Infections|Infections]] of the peripheral nervous system
* [[Neoplasm|Neoplasms]] - [[tumors]] of the [[brain]] and its meninges ([[brain tumor]]s), [[spinal cord]] [[tumor]]s, [[tumor]]s of the peripheral [[nerves]] ([[neuroma]])
* [[Movement disorder|Movement disorders]] such as [[Parkinson's disease]], [[Huntington's disease]], [[hemiballismus]], [[tic disorder]], and Gilles de la [[Tourette syndrome]]
* [[Demyelinating disease|Demyelinating diseases]] of the central nervous system, such as [[multiple sclerosis]], and of the [[peripheral nervous system]], such as [[Guillain-Barré syndrome]] and [[chronic inflammatory demyelinating polyneuropathy]] (CIDP)
* [[Spinal cord|Spinal cord]] disorders - [[tumor]]s, [[infection]]s, [[Physical trauma|trauma]], malformations (e.g., myelocele, meningomyelocele, tethered cord) 
* Disorders of peripheral [[nerve]]s, [[muscle]] ([[myopathy]]) and [[neuromuscular junction]]s
* Traumatic injuries to the [[brain]], [[spinal cord]] and peripheral [[nerve]]s
* Altered mental status, [[encephalopathy]], stupor and [[coma]]
* [[communication disorder|Speech and language disorders]]

== Educational requirements ==
A neurologist's educational background and medical training varies with the country of training.  In the United States and Canada, neurologists are physicians who have completed postgraduate training in neurology after the completion of medical school and attainment of the allopathic (MD, MBBS, MBChB, etc) or osteopathic (DO) degree.

Neurologists complete a minimum of 10 years of postsecondary education and clinical training. In the majority of cases this training includes obtaining an undergraduate degree (a few medical schools will admit students with as little as two years of undergraduate education), a medical degree (4 years), and then completing a four-year residency in neurology. The four-year residency consists of one year of internal medicine training followed by three years of training in neurology.

Many neurologists also have additional subspecialty training (fellowships) after completing their residency in one area of neurology such as stroke, epilepsy, neuromuscular, sleep medicine, pain management, neuroimmunology, clinical neurophysiology, or movement disorders.

== Testing examinations ==
 
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. Localization of the pathology is the key process by which neurologists develop their differential diagnosis. Further tests may be needed to confirm a diagnosis and ultimately guide therapy and appropriate management.

==Clinical tasks==
===General caseload===
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]]. In some countries, additional legal responsibilities of a neurologist may include making a finding of [[brain death]] when it is suspected that a [[patient]] is [[deceased]]. Neurologists frequently care for people with hereditary ([[gene|genetic]]) diseases when the major manifestations are neurological, as is frequently the case. [[Lumbar puncture]]s are frequently performed by [[neurologists]]. Some neurologists may develop an interest in particular subfields, such as dementia, movement disorders, [[headache]]s, [[epilepsy]], sleep disorders, chronic pain management, [[multiple sclerosis]] or neuromuscular diseases.

===Overlapping areas===
There is some overlap with other specialties, varying from country to country and even within a local geographic area. Acute [[head injury|head trauma]] is most often treated by [[neurosurgeon]]s, whereas [[sequela]] of head trauma may be treated by neurologists or [[Physical medicine and rehabilitation|specialists in rehabilitation medicine]]. Although stroke cases have been traditionally managed by internal medicine or hospitalists, the emergence of vascular neurology and endovascular neurosurgery as disciplines has created a demand for stroke specialists. The establishment of [[JCAHO]] stroke centers has increased the role of neurologists in stroke care in many primary as well as tertiary hospitals.   Some cases of nervous system [[infectious disease]]s are treated by infectious disease specialists. Most cases of [[headache]] are diagnosed and treated primarily by [[general practitioner]]s, at least the less severe cases. Similarly, most cases of [[sciatica]] and other mechanical radiculopathies are treated by general practitioners, though they may be referred to neurologists or a surgeon (neurosurgeons or [[Orthopedic surgery|orthopedic surgeons]]). [[Sleep disorders]] are also treated by [[Pulmonology|pulmonologists]]. [[Cerebral palsy]] is initially treated by [[Pediatrics|pediatricians]], but care may be transferred to an adult neurologist after the patient reaches a certain age.

[[Clinical_neuropsychology|Clinical neuropsychologists]] are often called upon to [[Neuropsychological_assessment|evaluate]] [[brain]]-[[Human_behavior|behavior]] relationships for the purpose of assisting with [[differential diagnosis]], planning [[Physical_medicine_and_rehabilitation|rehabilitation]] strategies, documenting [[cognitive]] strengths and weaknesses, and measuring change over time (e.g., for identifying abnormal [[aging]] or tracking the progression of a [[dementia]]).

===Relationship to clinical neurophysiology===
In some countries, e.g. USA and Germany, neurologists may specialize in [[clinical neurophysiology]], the field responsible for [[electroencephalography|EEG]], [[nerve conduction study|nerve conduction studies]], [[electromyography|EMG]] and [[evoked potentials]]. In other countries, this is an autonomous specialty (e.g. United Kingdom, Sweden).

===Overlap with psychiatry===
{{see|Psychoneuroimmunology|Neuropsychiatry}}

Although many [[mental illness]]es are believed to be neurological disorders affecting the [[central nervous system]], traditionally they are classified separately, and treated by [[psychiatrists]]. In a 2002 review article in the [[American Journal of Psychiatry]], Professor Joseph B. Martin, Dean of [[Harvard Medical School]] and a neurologist by training, wrote that 'the separation of the two categories is arbitrary, often influenced by beliefs rather than proven scientific observations. And the fact that the brain and mind are one makes the separation artificial anyway.' (Martin JB. The integration of neurology, psychiatry and neuroscience in the 21st century. Am J Psychiatry 2002; 159:695-704)

There are strong indications that neuro-chemical mechanisms play an important role in the development of, for instance, [[bipolar disorder]] and [[schizophrenia]]. As well, 'neurological' diseases often have 'psychiatric' manifestations, such as post-[[stroke]] [[clinical depression|depression]], depression and [[dementia]] associated with [[Parkinson's disease]], mood and cognitive dysfunctions in [[Alzheimer's disease]], to name a few. Hence, there is no sharp distinction between neurology and [[psychiatry]] on a biological basis - this distinction has mainly practical reasons and strong historical roots (such as the dominance of [[Freud]]'s [[psychoanalysis|psychoanalytic theory]] in psychiatric thinking in the first three quarters of the 20th century - which has since then been largely replaced by the focus on [[neurosciences]] - aided by the tremendous advances in [[genetics]] and [[neuroimaging]] recently.)

== References ==
<references/>

==External links==

* [http://www.efns.org  European Federation of Neurological Societies]
* [http://www.blackwell-synergy.com/loi/ene  European Journal of Neurology]
* [http://www.ninds.nih.gov  National Institute of Neurological Disorders and Stroke (NINDS)]
* [http://www.fastmag.info Fast-MAG] The Field Administration of Stroke Therapy – Magnesium Phase 3 Clinical Trial
* [http://stroke.ahajournals.org/ Journal of The American Stroke Association] 
* [http://www.tg.com.au/?sectionid=46 Therapeutic Guidelines - Neurology]
*[http://www.neurologia.com/ Revista de neurologia] 

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[[Category:Neurology]]
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