Your first neurological assessment

1. First, we go through a few detailed questions to get a better understanding of the issues you’re facing.

2. Next we’ll perform a neurological screening. If we can diagnose a problem, we’ll also discuss possible treatment options.

3. If nothing can be diagnosed because further tests are needed, then we’ll order these investigations. Possible investigations include blood tests, x-rays and a CT scan or an MRI.

Blood tests

Blood tests are used to pick up specific health concerns like muscle disorders and diseases, or infections in the spinal chord, brain and bone marrow. It’s also used to look for congenital or genetic diseases.

X-Rays

X-Rays are used to detect certain defects, infections and other neurological disorders. It’s also used to look for sinus problems, identify any fractures in your skull, or possibly to detect tumours.

CT and MRI Scans

Computed tomography (CT) and magnetic resonance imaging (MRI) scans look at your brain and your spine in order to detect disorders, injuries and diseases. They serve a similar purpose, but accuracy of the tests depends on the presenting problem.

These scans are done by radiographers and analysed by radiologists.

Your follow up visit.

When you come back we’ll discuss your response to treatments and look at presenting results.

Then, an examination is performed to determine if symptoms are progressing. From this we’ll discuss further possible options for your treatment.

Electroencephalogram | EEG

During an EEG your brainwaves are recorder on a computer. We analyse the frequency of brain activity and also look at the shape and behaviour of your brain waves.

EEG’s are used to look for possible seizures, epilepsy, dementia, pseudo-dementia and encephalopathies

An EEG can last between 20 minutes – 24 hours, depending on a few things. It’s a completely non-evasive process. Leads are attached to your scalp with a gel–like substance, and is removable by washing your hair.

Nerve conduction studies and electromyography | EMG

We use these tests to look for motor neurone conditions.

During examination we test how adequately your nerves can transmit impulses. Using a needle we can let a small electric current pass through a specific nerve. Your nerve activity gets displayed on a screen in the form of waves.

We’ll test the nerves once while your muscle is relaxed, and once while it is contracted.

• If your waves are not showing normal, it could be a sign of either muscle disease or nerve disease.
• Lower motor neuron conditions are caused by nerve, nerve root or muscle disorders. Upper motor neuron conditions by brain and spinal cord disorders.

Dystonia

This is a type of neurological movement disorder. When you have it, certain muscles in your body contracts involuntarily. This can either affect a specific part of your body, different parts at the same time or your whole body.

Most common areas that are affected by dystonia include:

• Neck
• Eyelids
• Jaw or tongue
• Vocal chords
• Hands and forearms

Blepharospasm

This is a fairly rare disease and is identified by abnormal contraction or twitching of the eyelids. Symptoms of blepharospasm can vary from mild to severe, disappear for days at a time or continuing persistently.

Blepharospasm can also be referred to as focal dystonia, because the muscles around your eyes are contracting involuntarily.

Spasticity

Spasticity is also a condition in which some muscles in your body contract involuntarily. However spasticity is mostly caused by brain or spinal chord damage, strokes, meningitis or encephalitis (inflammation of the brain). Patients with Cerebral Palsy or Multiple Sclerosis may also suffer from spasticity.

Besides muscle contraction, muscle fatigue, stiffness and pain, spasticity can also cause urinary tract infections, chronic constipation, fever or other systemic illnesses and pressure sores

Hyperhidrosis

Hyperhidrosis is excessive sweating. Even though it is not necessarily a health risk nor does it affect the functioning ability of your muscles, it’s an embarrassing problem that can affect your day-to-day life.

This excessive sweating is not only cause by physical activity, but can also be triggered by slight heat change, anxiety and other emotions.

Sometimes hyperhidrosis is a symptom caused by other health issues such as diabetes, menopause, thyroid problems or low blood sugar.

Medical copywriting is the magic that happens between medicine and marketing. It is the art of making the science understandable, concise, and pleasing while keeping the claims accurate.

Medical journals are often cumbersome and filled with complex jargon. Converting jargon to usable facts is one of Dr Mandita’s expertise. It is an artistic use of science.

In her tenure as a medical manager at Roche, a pharmaceutical company, she gained invaluable sales and marketing skills. Dr Mandita has also worked as a research clinician for the Tuberculosis trials consortium and was overseeing clinical trials during her term as medical manager. She continues to be involved in research trials.

It is this unique fusion of neurology, sales and marketing, research knowledge as well as her love for words that give her the edge.

The fact that she is a practicing neurologist with her own private practice and state hospital experience are invaluable in neurology writing as she has real time insight into prescribing patterns and idiosyncrasies that apply to the African population.

Dr Mandita is also an avid blogger who pours her heart out on vibewithvu.com