According to the 2018 demographic study of the medical field, referring to doctors in Brazil, Neurology has 5,104 professionals, representing 1.3% of all specialist titles.
According to the survey, there are growth trends and society’s interest in neurological care, indicating a promising area for professionals.
Learn more about the specialty and area of expertise:
What is the neurologist?
The neurologist is the specialist doctor who works in the neurological area and is dedicated to the study, diagnosis, interventions and treatments of diseases or conditions that affect the nervous system – brain, spinal cord, nerve roots and nerves – and muscles (myopathies).
This includes any dysfunction or condition that is identifiable through mutations:
- Genetics (such as changes in DNA);
- Biochemicals (such as changes in enzyme functions);
- Tissues (such as changes in the physical structure of tissues).
That is, neurology is the specialty indicated when there are conditions of physiology or anatomy that affect the nervous system and generate impacts on health or body structures.
The nervous system (SN) is divided between the peripheral (composed of nerves that start in the brain and spinal cord) and the central (composed of the cerebellum, brain, bulb and spinal cord).
This structure is responsible for sending and receiving signals or stimuli from the whole organism. It may seem difficult to think why a neurologist treats sound changes, for example.
But to hear sounds – or to feel touches, to move muscles, to learn music or to remember where the keys were left – it is necessary that the communication between the central nervous system and the rest of the body is adequate and functional.
That is, the functions of the whole organism can be affected if there are pathologies or neurological changes.
Thus, the complex system is responsible for sending and receiving various signals from the body, making it possible to interact with the environment.
Therefore, any dysfunction or change in the region can result in varied symptoms and manifestations, which can be isolated (for example, muscle pain) or joint (for example, reduced memory, muscle loss and strength and changes in metabolism).
Neurology can be divided into 3 main lines, which are General Neurology, Child Neurology and Neurosurgery. They are worked on during the specialization, aiming at the improvement of the neurologist.
Our body is composed of the nervous system (SN) that emits and receives signals, or nervous impulses, maintaining the functioning of the entire organism.
When there are changes in this process, the condition is related to neurological functions.
Together, they can be considered a system that involves cranial nerves, motor responses (muscle movement), sensory aspects (such as touch, smell, taste), awareness and cognition (perception and ability to respond to external stimuli).
To understand the complex system that integrates neurological functioning, it is necessary to remember that SN is the center of the organism and that it participates in our perception of external stimuli.
Feeling smells, touches and perceiving lights, for example, is only possible through its correct functioning.
But in addition, it acts constantly by sending and receiving signals from the whole body – whether to run a race or to keep the heart beating.
Sometimes the body is affected by neurological conditions that cause pain. But the pain itself (that caused by a burn, for example) only occurs because of this complex system.
When fire or hot water touches the skin, sensitive receptors are stimulated and emit nerve impulses.
These impulses travel through the peripheral nerves and reach the spinal cord, which generates motor responses that are returned to the hand, causing the muscles to contract and be removed from the fire.
Then, nerve stimuli are sent to the brain, which processes the information, generating:
- Burning sensation, burning and physical discomfort;
- Interpretation of pain and resolution (for example, putting your hand in running water);
- Stimulation of biochemical processes to resolve the injury (immune system works by controlling tissue damage).
And there needs to be no injury for the neurological system to perform its functions.
Touching objects, responding to smells, exercising, writing, singing and breathing are only possible activities due to the correct neurological functioning.
The neurologist is the specialist medical professional, dedicated to the study, diagnosis, treatment and monitoring of diseases or conditions involving the nervous system , that is, the brain.
Any disease or change in the region can trigger responses in the rest of the organism, as the organ is involved with all its functioning. Therefore, there are several manifestations that can be treated or monitored by the professional.
Even though neurology is a medical specialty, the field has 3 major lines, making the professional graduate as a neurosurgeon, clinical neurologist and child neurologist.
What does a neuropediatrician (child neurologist) do?
Children and adolescents may need to go to the neuropediatrician’s consultation as well. In these cases, a series of problems can be accompanied by professionals, such as learning or locomotion difficulties, as well as behavioral changes or headaches.
Sleep disorders, muscle problems, hyperactivity and even autism may require follow-up with a child neurologist.
In the first consultation, the doctor will assess the child, raising his medical history, as well as requesting tests, if necessary.
The clinical neurologist professional is trained in general care, focusing on the action and interaction of medications, as well as the most common conditions and diseases in clinical care.
That is, it is that doctor who usually provides care in health centers and offices.
Although not only reduced to these conditions, some pathologies or disorders that can be treated by the neurologist include:
- Multiple sclerosis;
- Memory loss;
- Low back pain;
- Cerebral thrombosis.
The professional has training more focused on clinical care, the one done in health centers, but with a focus on childhood.
The diseases and conditions that most affect children in the pediatric phase are, in general, distinct from those that affect adults, some of the most frequent are:
- Delayed speech or walking;
- Cell paralysis;
- Hypotonia (muscle weakness);
- School difficulty;
- Headaches or headache;
- Hyperactivity and attention deficit (ADHD);
- Epilepsy and seizure;
- Sleep disorders (such as insomnia, night terror, etc.);
- Cerebral palsy;
- Inborn errors of metabolism.
Therefore, in addition to specific knowledge of organic functioning during development, attention must be paid to the most common conditions of the phase.
The professional works in surgical centers and hospitals, having a training focused on the conditions that require surgical intervention and intensive treatment, whether emergency or scheduled.
Among some conditions that may be followed by the neurosurgeon are:
- Tumor cerebral;
- Tumor of peripheral nerves;
- Brain aneurysm;
- Herniated cervical and lumbar disc;
- Degenerative diseases of the spine;
- Traumatic spine fractures;
- Head trauma.
Symptoms: when to see a neurologist?
It is not only when there are emergencies that the neurologist should be consulted. For example, healthy people with a family history of neurological diseases can consult the specialist. But some symptoms deserve attention.
They are not always the source of the problem, so it is important to be aware of the body’s signs and always seek help and professional guidance.
Among the manifestations that may indicate a visit to the office are:
Headaches, or headaches, are common conditions. It is quite difficult for someone who has never suffered from headache, regardless of the cause of the pain. Flu, infections, prolonged exposure to the sun and even vision problems can trigger the discomfort.
But when it persists, the ideal is to seek a specialist. When the pain is acute and continuous, and may be accompanied by nausea and vomiting, the warning light comes on.
Numbness and tingling
Tingling and numbness in certain parts of the body for no apparent reason (such as clothing that compresses circulation or sitting for long hours) can be a warning sign for various diseases.
In this case, other symptoms and manifestations deserve attention, such as vertigo, mental confusion, reduced vision and difficulty in speaking.
Sleep disorders or changes
Having a good night’s sleep is essential for the health of the body and for the disposition the next day. Although essential, many people suffer from sleep disorders that may have a neurological origin.
Waking up a lot during the night or realizing that you snore too much can be indicative of apnea, for example, which is the interruption of breathing during sleep.
Reduction of physical strength, progressive muscle weakness and difficulties in coordinating movements can be indicative of neurological changes, since the commands that reach the muscle come from the brain region.
When these signs and symptoms occur frequently and are associated with changes in the ability to speak, chew, breathe or swallow, it is important to seek medical advice.
Due to the diversity of symptoms and manifestations that can be associated with the neurological field, it is always necessary to be aware of the symptoms, such as:
- Dizziness and vertigo;
- Vision reduction;
- Concentration difficulties;
- Memory difficulties;
- Reduction of skin sensitivity;
- Pain without apparent cause;
- Muscle spasms.
In general, it may be advisable to seek guidance from a general practitioner for more general conditions, such as dizziness or changes in gait (walking or running). The doctor will evaluate the pictures and recommend a specialized consultation, if necessary.
What conditions and diseases does the neurologist treat?
The origins of these problems can also be diverse, resulting from lifestyle, infections, genetic conditions, food, environmental factors, physical injuries and accidents.
Some very common conditions that can be treated by the neurologist are:
Obstructive sleep apnea
Sleep apnea syndrome is characterized by an obstruction, partial or total, of breathing during sleep, which can last between 10 and 20 seconds.
The pictures can cause snoring, excessive sleep during the day, feeling of suffocation when waking up in the middle of sleep and dry mouth.
Some factors are related to the condition and favor the condition, such as:
- Alteration of the muscles of the larynx;
- Lack of coordination of the respiratory muscles;
- Tonsils growth.
Difficulty initiating sleep, keeping it constant at night, or waking up very early can often be signs of insomnia .
The causes are diverse: anxiety , agitation, food, biochemical changes, among others.
When prolonged, the condition impacts on the person’s routine, disposition and physical and mental productivity.
Clonic hemifacial spasm
Involuntary and painless contractions (although generally uncomfortable) that most often occur on only one side of the face are called clonic hemifacial spasm.
The condition rarely affects the entire face, being caused by dysfunctions in the cranial nerve (which is responsible for the muscular movements of the face).
The most common known causes involve poorly positioned arteries that compress the nerve, use of drugs, genetic factors or diseases that limit brain function.
Peripheral neuropathy is a condition that affects peripheral nerves. As they are responsible for carrying information from the brain to the body, a number of manifestations can occur, such as:
- Reduction or loss of sensation;
- Difficulty moving;
- Muscle atrophy;
- Tingling and numbness.
The causes are diverse and can include the use of medications (such as statins, antibiotics and chemotherapy), autoimmune diseases (such as rheumatism and lupus ), poisoning (by mercury, pesticides or lead), and inflammation of the nerves by physical trauma (falls or blows) ).
Parkinson’s disease affects the central nervous system, being a degenerative, chronic and progressive condition. The patient has a reduction in neurotransmitters (substances that participate in the sending and receiving of messages between the brain and the body).
Among the most common symptoms are tremors, stiffness and sluggishness, in addition to decreased smell or bowel functions.
Inflammatory diseases of the central nervous system
Some inflammatory or infectious conditions can cause damage to the nervous system and are caused by agents such as viruses, bacteria and fungi. Between them:
- Bacterial meningitis and other causes (fungi or unidentified causes);
- Abscess and granuloma inside the skull.
Dystonias are slow and frequent involuntary muscle contractions, which can even result in incorrect postures or muscle twists.
The main causes include:
- Medications (such as antipsychotics or antiemetics);
- Wilson’s disease;
- Multiple sclerosis;
There are conditions that can affect movement (walking, picking up things, moving your arms) due to vascular, degenerative or infectious changes.
These manifestations are classified as movement disorders and comprise tremors, prolonged involuntary contractions, frequent or excessive muscle spasms .
It occurs due to abnormal electrical discharges in the brain, resulting in intense, sudden and involuntary contractions of the body, called epileptic seizures. The causes can be quite variable. In adults, stroke is one of the main ones, whereas in children, metabolic changes are more common.
The neurodegenerative condition is the most common in the world, responsible for the temporal and spatial disorientation that affects older people. In addition, along with aging, the family history of the disease is a risk factor that deserves attention.
A number of manifestations can occur, affecting language, the ability to calculate, memory and behavior in general.
Also called a stroke, the stroke can be caused by the obstruction of some artery, which causes the lack of blood in the brain, or by the rupture of a blood vessel, which generates bleeding in the region.
About 70% of women and 50% of men suffer at least 1 episode per month with headache.
Despite being a very uncomfortable symptom, it is not always treated properly, as almost 90% of all who suffer from constant headaches self-medicate at least 3 times a week and, therefore, do not discover the source of the problem.
Multiple sclerosis is an autoimmune disease that affects the brain region. The condition develops when the organism alters its functioning and, instead of the cells of the immune system protecting the system, they start to attack it.
Inflammation occurs in regions of neurons called the myelin sheath (a fundamental part of the transmission of nerve impulses).
With the incorrect communication of the nervous system, symptoms such as reduced balance, changes in vision, loss of muscle strength and reduced locomotion can manifest themselves.
The neuralgia is a condition resulting from structural or functional changes in the nerves that cause severe pain to a similar cut, burn or shock.
Several nerves can be affected, but the most common are those in the face and neck.
The condition is considered to be one of the worst and most severe pains. The trigeminal nerve is located in the face and is responsible for the sensitivity of the region.
When there is a lesion in its covering layer (called myelin sheath), electrical discharges occur that cause the sensation of shocks on the face.
Although in some patients it is not possible to identify what generates the injury, some conditions involved include:
- Inflammation in regions close to the nerve;
- Herpes virus infection;
- Tumors on the face;
- Cerebral vascular changes.
Spinal cord diseases
Also called myelopathies, diseases of the spinal cord are the result of infections, autoimmune diseases, systemic diseases capable of affecting the spinal cord.
They can cause paralysis, reduced sensitivity and voluntary muscle control.
Guillain-Barré syndrome is a polyneuropathy, as there is a malfunction of several peripheral nerves in the body.
When the condition is acute, that is, it appears suddenly, it is called Guillain-Barré Syndrome. However, if the symptoms persist for more than 8 weeks, the condition is called chronic inflammatory demyelinating polyneuropathy.
Among the causes of chronic disease (chronic inflammatory demyelinating polyneuropathy) are nerve compressions, autonomic dysfunctions, lack of vitamin B12 or complications of diabetes , for example.
The term is used to refer to a group of inherited diseases that affect the muscles. The most common are congenital myopathies of the type:
- Nemaline : usually causes weakness of the respiratory muscles, face, neck and feet;
- Myotubular : affects men and causes skeletal, facial, respiratory muscle weakness;
- Core : also called central nuclear, the condition causes mild weakness in the muscles near the trunk and face;
- Disproportionate fibrous : causes weakness in the face, neck, trunk and limbs, usually accompanied by changes in the skeleton (bodily dysmorphia).
The condition is considered the main disabling factor of childhood, which results from a brain injury still in the organ’s development phase (that is, from pregnancy to 2 years of age).
Paralysis is irreversible and can have an impact on body movement due to muscle stiffness. But, in addition, they can occur:
- Breathing difficulty;
- Cognitive changes;
- Sensory reduction (decreased hearing, for example).
The examinations made by neurologists consist of surveying the patient’s family history, their complaints and symptoms, in addition to the physical and neurological examinations that can be requested.
The service depends a lot on the type of environment and condition. For example, emergency situations are very specific and require different interventions.
But in a clinical consultation, in general, the neurologist can make assessments such as:
- Nutritional condition;
- Measure at temperature;
- Analyze skin and body regions;
- Examine bone and muscles;
- Check breathing and heart rate.
In addition, there may be a survey of neurological capabilities (memory, locomotion, speech) and the possibilities related to the patient’s symptoms. For example, use of medication, changes in routine, behavioral habits.
There are also complementary exams that can be part of the neurological assessment, helping the professional to diagnose or eliminate possibilities. The most common can include:
The exam consists of a puncture (blood collection) in the lumbar spine, which is important for the assessment of various infectious, inflammatory or neoplastic conditions that can affect the nervous system.
In general, the exam does not require specific preparations, but it is contraindicated in patients with hypertension or who use anticoagulant drugs.
Electroneuromyography is an exam that aims to analyze the function of nerves and muscles and identify changes in the communication between the two.
Initially, the examination consists of placing adhesive electrodes on the skin capable of emitting stimuli to the nerves.
The body’s responses are evaluated and allow to identify changes or dysfunctions in the sensory or motor responses.
Then, an electrode is used with a small needle inserted into the muscle tissue. At this time, the activity is performed directly on the muscle fiber (at rest and in motion).
The test may be ordered in some conditions such as amyotrophic lateral sclerosis, diabetic neuropathy, carpal tunnel syndrome or Guillain-Barré syndrome.
The examination records brain activity by placing receptors (electrodes) that are attached to the scalp. The test is non-invasive and does not hurt, and any age can perform the electroencephalogram , including young children.
In order to analyze the circulation and the main blood vessels in the skull, the transcranial doppler emits low frequency waves.
The procedure is painless and non-invasive, being indicated for dizziness, vertigo, stroke, intracranial hypertension and for the evaluation of the integrity of the blood circulation structures.
Blood tests are ordered for specific purposes, according to the neurologist’s assessment. They consist, in general, of normal blood collections and can be used to analyze the presence of diseases, infections and the presence of substances (drugs or medications).
There are a number of tests that can be ordered to visually assess neurological structures, such as magnetic resonance imaging, computed tomography and ultrasound.
In general, tests are requested when there are specific suspicions or when it is intended to rule out anatomical or functional changes in the brain region.
Neurological physiotherapy is a postgraduate course that covers the specific notions and knowledge of neurology and physiotherapy, so that the specialties are integrated and complement each other.
Paying attention to the functions of motor coordination, balance, strength and movement, the neurological physiotherapist can resort to physical stimulation, electrostimulation and movement simulators to assist in the recovery of the patient and in maintaining the integrity of the organism.
Thus, the neurological physiotherapist diagnoses, treats and accompanies patients with changes or conditions related to the brain, brainstem, spinal cord, peripheral nerves and neuromuscular junctions.
Among some conditions that can be indicated to the specialist are cerebral palsy , multiple sclerosis, head trauma and stroke.
It is worth pointing out that the specialty is recognized by the Federal Council of Physiotherapy and Occupational Therapy (COFFITO), and it is mainly through specific functional exercises and adaptations of the daily routine that the neurologist physiotherapist works.
That is, during consultations, the patient performs sessions of activities aimed at recovering or improving the necessary motor and functional systems.
In addition, according to everyday difficulties (such as picking up objects, walking, sitting, driving), the professional assists in the patient’s adaptation, discovering and establishing better ways to maintain autonomous life.
To become a neurologist, it is necessary to become a doctor and obtain registration with the Regional Council of Medicine (CRM). After basic training, the professional makes a specialization of 3 years, acquiring theoretical, practical and scientific knowledge, being inserted in the dynamics of neurology.
During the specialization, the doctor will improve his / her ability to carry out anamnesis (clinical examination) directed at neurology, make the diagnosis of the main neurological diseases and their respective treatments.
Therefore, it takes at least 9 years of study – 6 of medicine and 3 of specialization in neurology – to become a neurologist.
After passing through the formative years, the professional is able to work in some areas, such as:
The neurologist or neuropediatric professional can perform consultations in clinics, private offices or through the Unified Health System (SUS).
In clinics, care can be diverse, including occasional complaints of headache (headache) or conditions that require prolonged and continuous monitoring, as in neurodegenerative diseases (for example, alzheimer).
Each patient needs an in-depth assessment so that the best treatment can be established.
This means that, at times, the neurologist may be the only physician who accompanies the patient or may be part of multidisciplinary treatment, together with psychologists, pediatricians, endocrinologists and physiotherapists, for example.
Neurosurgeons can work, especially in emergency environments, hospitals and surgical centers that require highly complex care and care.
Accidents, traumas, crashes, emergency conditions (such as strokes or strokes) and scheduled surgeries can be part of the neurologist’s hospital routine.
It is important to highlight that the neurosurgeon also needs to have specific knowledge to treat adults and children, as soon as the systems and anatomy behave in different ways.
But hospitals can provide care in the non-emergency sphere, through scheduled consultations, for example. Thus, the neurologist also finds a field in continued clinical care in hospitals.
The salary of a neurologist varies according to the sector in which he works (public or private), as well as his specialty and routine of care. Considering the data from the Ministry of Labor, the average salary is between R $ 4 thousand and R $ 10 thousand per month.
The average salary of a neurosurgeon, according to the Ministry of Labor, is between R $ 4,000 and R $ 15,000, according to the professional’s training and area of expertise. The values have wide margins as they are an average estimate of participants from all axes (SUS, private or private system and health plans).
The Brazilian Academy of Neurology (ABN) is a non-profit civil entity that aims to bring together neurology professionals and students from Brazil.
The organization was founded on May 5, 1962, in Rio de Janeiro, and currently represents Brazilian Neurology in the “ World Federation of Neurology” , which brings together federal entities in neurology from all over the world.
As the role of professional associations, ABN assists in the dissemination of licensed educational institutions, scientific congresses, service guidelines, professional updates, promotion and development of Brazilian neurology.
Neurology comprises a complex and diverse area, in which specialists work to guarantee a better quality of life for the patient – whether by maintaining health or solving changes and diseases.
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