Neurology is the medical specialty that deals with the disorders of the nervous system and musculature. The nervous system includes the brain, the spinal cord, and the peripheral nerves.
What are the neurological diseases? Neurological disorders can be divided into the following groups:
Headache can be a symptom of a serious hereditary disease, e.g. of a brain tumor. In most cases, however, there is no cause for headaches, so that one speaks of primary headache disorders. The most common headache disorders are migraine and tension type headache.
Vascular Diseases of the Brain
More than any other body, the brain is dependent on an undisturbed oxygen and blood supply. Circulation disorders of the brain can lead to cerebral infarctions (strokes) with partial paralysis and speech disorders. Similar symptoms can also be caused by cerebral hemorrhage. The risk factors which lead to a damage to the brain-supplying blood vessels and thus to stroke in the long term are the same, which also lead to myocardial infarction: hypertension, smoking, sugar disease, increased blood fat content and lack of exercise.
Infectious diseases of the nervous system
The brain can be infected like other organs of pathogens, bacteria or viruses. When the meninges are affected, one speaks of meningitis. If the brain is directly affected, there is encephalitis.
Multiple sclerosis is a chronic inflammatory disease of the brain and spinal cord, which is not caused by pathogens, but is the result of a wrong regulation of the immune system. In most cases, multiple sclerosis manifests itself with repeated episodes of disease that lead to changing and different symptoms (visual disturbances, paralysis, sensory disturbances) (relapsive multiple sclerosis). After a prolonged period of disease, multiple sclerosis can enter a chronic stage with permanent, gradually increasing disability (secondary chronic-progressive multiple sclerosis).
Tumors can form in the brain and spinal cord as in other organs. Frequent brain tumors are gliomas arising from the connective tissue cells of the brain, meningiomas originating from the brain membranes, and lymphomas arising from lymphatic tissue. In the brain, metastases can also settle from other malignant tumors.
Neurodegenerative diseases are chronic hereditary diseases in which a progressive disturbance of certain brain functions occurs without bleeding disturbances or inflammation. A part of these diseases is hereditary; in most cases, no cause can be grasped. The most common and most important neurodegenerative disease is Alzheimer's disease, which mainly affects the cerebral cortex and leads to a progressive loss of memory and other mental abilities. In other neurodegenerative diseases, movement disorders are the main focus. Parkinson's disease is accompanied by a slowing of movement, muscle stiffness and tremor. Typical signs of ataxia or degenerative pancreatic disease are gait uncertainty and coordination disorders.
Diseases of the peripheral nervous system
The injury of individual peripheral nerves can occur due to injury or mechanical pressure. Examples are carpal tunnel syndrome and sulcus ulnaris syndrome. Diseases in which peripheral nerves are diffuse injured are referred as polyneuropathies. Polyneuropathies are characterized by numbness, pain, and paralysis that begin at the feet. The causes of polyneuropathies are manifold. They are most commonly caused by sugar or alcohol abuse.
In many neurological disorders, muscle weakness and muscle wasting occur. The causes for this can lie in the brain, spinal cord and peripheral nervous system. In the case of the actual muscular diseases, however, the cause lies directly in the muscle. Many muscle diseases are hereditary. There are also acquired muscular diseases, e.g. Muscle infections (myositis). In the case of myasthenia, as a result of an inflammatory damage of the transfer points between the nerve and the muscle (neuromuscular end plate), stress-dependent muscle weakness occurs.
How are neurological diseases diagnosed? Neurological diagnosticsNeurological examination
In neurological diagnostics, an exact questionnaire (anamnesis) and neurological examination play an outstanding role. By careful neurological examination, it is often possible to precisely locate disturbances in the brain or spinal cord. In the course of the neurological examination the brain nerves, the muscular strength, the motor function, the sensitivity, the coordination, the muscle tone, the gait and the balance are thoroughly examined.
The electrical currents of the brain are measured with the EEG. In this case, general slowdowns, shaped changes, or typical epileptic potentials can be demonstrated.
In essence, the evoked potentials are used to measure the conductivity of various nerve tracts, e.g. the audit trail (AEP) or the sensory track (SEP). These can be slowed or weakened in certain diseases.
The perfusion of the brain-supplying vessels and of the vessels in the brain is measured by means of doppler sonography. Closures or the extent of constricted sites of these vessels can be detected and controlled.
Electroneurography / Electromyography
In certain diseases it is necessary to determine the conductivity of the nerves on the arms and legs with the electro-neurography. With electromyography, the electrical activity of the muscle is visualized and assessed. This is important both for the assessment of nervous and muscular disorders.
Neuropsychological test diagnostics
Standardized test procedures help to examine the brain performance. With regard to attention, memory, spatial imagination or language ability. This is particularly important in diseases of the brain which can lead to impairment of cognitive performance, e.g. Stroke, epilepsy, cerebral palsy, or dementia.
An increasingly important role in neurological diagnostics is played by imaging techniques. Specifically, these are conventional X-ray procedures, myelography, angiography, computed tomography (CT), and magnetic resonance tomography (MRI). These procedures are performed by specialized radiologists (neuroradiologists).