Neurologist and neuropathologist: are they the same doctor and what do they do

Movements become unsteady, speaking and swallowing are difficult, and memory fails. At that moment the question arises: who should I go to — a neurologist or a neuropathologist.

Neurologist and neuropathologist: is it the same specialty

The short answer: it is the same doctor. A neurologist is a specialist with a higher medical education and specialization in neurology; until the 1980s in the Soviet Union the specialty was called "neuropathologist", and the old word is still found in print publications, although the official nomenclature of medical specialties includes only "neurologist".

The difference exists only in foreign terminology: there a neuropathologist is a specialist in the pathomorphology of the nervous system, while here that person is called a neurohistologist. The path to the specialty is the general medicine or pediatric faculty of a medical university, then a two-year residency and a certificate.

What the neurologist does

Neurology studies the nervous system in health and in pathology: the mechanisms of disease development, symptoms, diagnosis, treatment and prevention. The neurologist's area of attention includes the brain and spinal cord, cranial and peripheral nerves, nerve roots, the autonomic nervous system, neuromuscular junctions and muscles. When part of this network fails, a person has difficulty moving, speaking, swallowing, breathing or learning, and memory, senses and mood suffer.

There are very many diseases — more than 600 neurological conditions. Hereditary forms such as Huntington's disease and muscular dystrophy, developmental disorders such as spina bifida, degenerative processes in which nerve cells are damaged or die — Parkinson's disease and Alzheimer's disease. Stroke and other vascular catastrophes, traumatic brain and spinal cord injuries, epilepsy and other paroxysmal disorders, brain tumors, infections such as meningitis.

Neurological disorders, along with cardiovascular diseases, are a very common cause of disability in older people. Within the specialty there are separate areas: pediatric neurology, hereditary neurology, otoneurology, ophthalmoneurology, vegetology.

What symptoms bring patients to the neurologist

The reason is not a ready-made diagnosis but a feeling that the body has stopped obeying.

• difficulty with movement, impaired coordination and gait;
• difficulty with speech, swallowing, breathing;
• sensory disturbances (the doctor checks sensation during the examination);
• worsening memory and attention, changes in mood and behavior;
• pain along a nerve — neuritis and neuralgia.

If the complaints do not go away, that is a reason to make an appointment with a neurologist. If the complaints persist, you can book a routine appointment and sort things out without haste.

How the appointment proceeds and what tests are ordered for diagnosis

First, a conversation. The neurologist takes a history, asking in detail about the complaints, and then performs an examination: assesses mental state, cranial nerve function including vision, strength, coordination, reflexes, sensation and gait. This makes it clear whether there is a problem in the nervous system and where exactly it is located — localization is the key to differential diagnosis.

Next come additional procedures as indicated: electroencephalography, electroneuromyography, neuroimaging of the brain or spinal cord using MRI or CT, lumbar puncture, blood tests.

When urgent help is needed rather than a routine appointment

A routine appointment is for complaints that need to be sorted out without haste. Stroke is a life-threatening condition, and the queue for a neurologist does not apply here.

Going to a neurologist is not in itself a reason to call an ambulance; 103/112 — if speech, swallowing or breathing are impaired, if stroke is suspected or a seizure has started — in conditions that threaten life.

For a symptom that does not go away, there is only one road — to a specialist. This material is for reference: it explains who to go to and what to ask about, but does not replace a doctor's consultation.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer