You should consider consulting a neurologist if you experience persistent or severe symptoms affecting the nervous system. These include chronic or severe headaches that don't respond to over-the-counter medications, especially if they're sudden or accompanied by other symptoms; dizziness or vertigo that persists or recurs; unexplained weakness, numbness, or tingling in limbs; coordination problems or difficulty with balance; memory issues or confusion beyond normal aging; seizures or episodes of loss of consciousness; vision changes like double vision or partial vision loss; sleep disorders that significantly impact daily life; chronic pain without clear cause; tremors, tics, or involuntary movements; difficulty speaking, swallowing, or understanding speech; and changes in sensation, particularly if they affect one side of the body. Additionally, if you have a family history of neurological conditions like multiple sclerosis, Parkinson's disease, or Alzheimer's disease and notice potential symptoms, early evaluation by a neurologist can be beneficial for timely diagnosis and treatment.

Neurological diagnosis begins with a comprehensive neurological examination that assesses mental status, cranial nerve function, strength, reflexes, sensation, coordination, and gait. The patient's medical history and symptom description provide crucial context. Advanced diagnostic tools include neuroimaging such as MRI (showing detailed brain and spinal cord structure), CT scans (useful for detecting bleeding, tumors, or stroke), and functional imaging like PET or SPECT scans that reveal brain activity patterns. Electrodiagnostic tests include EEG (recording brain electrical activity, essential for epilepsy diagnosis), EMG and nerve conduction studies (evaluating muscle and nerve function), and evoked potentials (measuring nervous system response to stimuli). Laboratory tests may include blood work to detect infections, inflammatory markers, or genetic factors, and cerebrospinal fluid analysis via lumbar puncture to identify infections, inflammation, or biomarkers of specific conditions. Neuropsychological testing assesses cognitive function in detail. For certain conditions, genetic testing identifies hereditary disorders, and muscle or nerve biopsies provide tissue samples for microscopic examination. The diagnostic approach is tailored to each patient's symptoms and suspected conditions, often requiring a combination of these methods to reach an accurate diagnosis.

Stroke treatment has advanced dramatically in recent years. For ischemic strokes (caused by blood clots), the time window for administering clot-dissolving medication (tPA) has extended from 3 to up to 4.5 hours in select patients. Mechanical thrombectomy, a procedure to physically remove large clots using specialized devices, has revolutionized treatment for certain strokes and can be effective up to 24 hours after symptom onset in eligible patients. For hemorrhagic strokes (bleeding in the brain), minimally invasive surgical techniques have improved outcomes compared to traditional open surgery. Prevention strategies have also evolved, with more effective anticoagulants for atrial fibrillation that have fewer side effects and don't require frequent blood monitoring. Advanced imaging techniques now better identify high-risk patients who might benefit from preventive interventions. Mobile stroke units—ambulances equipped with CT scanners and specialized staff—bring stroke diagnosis and initial treatment directly to patients, reducing time to treatment. Telemedicine networks connect smaller hospitals with stroke specialists for remote consultation. Post-stroke rehabilitation has improved with technology-assisted therapies including robotic devices, virtual reality, and brain-computer interfaces. Public education campaigns focusing on the FAST acronym (Face drooping, Arm weakness, Speech difficulties, Time to call emergency services) have increased awareness of stroke symptoms and the importance of immediate medical attention.

Headaches are classified into primary headaches (not caused by another condition) and secondary headaches (resulting from underlying conditions). Primary headaches include migraine (characterized by moderate to severe throbbing pain, often with nausea, sensitivity to light/sound, and sometimes aura), tension-type headaches (presenting as bilateral pressure or tightness), cluster headaches (extremely severe pain around one eye occurring in clusters), and less common types like trigeminal autonomic cephalalgias. Secondary headaches may result from conditions like brain tumors, infections, trauma, vascular disorders, or medication overuse. Treatment approaches vary by headache type. For migraines, acute treatments include triptans, gepants (CGRP antagonists), ditans, NSAIDs, and anti-nausea medications. Preventive treatments for frequent migraines include anti-seizure medications, beta-blockers, antidepressants, CGRP monoclonal antibodies, and Botox injections. Tension headaches typically respond to over-the-counter pain relievers and stress management. Cluster headaches may require oxygen therapy, triptans, or preventive medications like verapamil. Non-pharmacological approaches include lifestyle modifications (regular sleep, meals, exercise, stress management), trigger avoidance, biofeedback, cognitive behavioral therapy, and neuromodulation devices. For medication overuse headaches, detoxification protocols help break the cycle. Secondary headaches require treatment of the underlying cause. A comprehensive headache management plan often combines medication with lifestyle modifications and is tailored to the specific headache type and individual patient factors.

Parkinson's disease treatment has evolved significantly and follows a multifaceted approach. Medication therapy remains the cornerstone, with levodopa (usually combined with carbidopa) being the most effective for motor symptoms. Other medication classes include dopamine agonists, MAO-B inhibitors, COMT inhibitors, anticholinergics, and amantadine, which may be used alone or in combination depending on disease stage and patient characteristics. For advanced Parkinson's with motor fluctuations, device-aided therapies offer additional options: Deep Brain Stimulation (DBS) involves surgically implanted electrodes that deliver electrical stimulation to specific brain regions; continuous infusion therapies like levodopa-carbidopa intestinal gel (Duopa) or apomorphine provide more consistent medication delivery. Non-motor symptoms, which significantly impact quality of life, are addressed with targeted treatments for depression, anxiety, sleep disorders, cognitive changes, and autonomic dysfunction. Rehabilitation therapies play a crucial role, with physical therapy improving mobility and preventing falls, occupational therapy maintaining independence in daily activities, and speech therapy addressing communication and swallowing difficulties. Exercise has emerged as a powerful intervention, with research showing it may slow disease progression and improve symptoms. Comprehensive care often involves a multidisciplinary team including neurologists, physical therapists, occupational therapists, speech therapists, mental health professionals, and nutritionists. While current treatments effectively manage symptoms, research continues toward disease-modifying therapies that might slow or halt progression, with several promising approaches in clinical trials.

Epilepsy is a neurological disorder characterized by recurrent, unprovoked seizures resulting from abnormal electrical activity in the brain. Seizures vary widely in presentation—from brief lapses in awareness to convulsions—depending on which brain regions are involved. Epilepsy has numerous potential causes including genetic factors, brain injuries, infections, stroke, tumors, or developmental disorders, though in many cases no specific cause is identified. Diagnosis typically involves a detailed medical history, neurological examination, EEG (electroencephalogram) to record brain electrical activity, and brain imaging (MRI) to identify structural abnormalities. Treatment primarily involves anti-seizure medications, with over 20 options available, each with different mechanisms, efficacy profiles, and side effects. Medication selection is individualized based on seizure type, patient age, gender, comorbidities, and potential side effects. For drug-resistant epilepsy (about 30% of cases), additional options include epilepsy surgery to remove the seizure focus, neurostimulation devices (vagus nerve stimulation, responsive neurostimulation, or deep brain stimulation), or dietary therapies like the ketogenic diet. Living with epilepsy involves important safety considerations including seizure precautions, driving restrictions based on seizure control, and awareness of potential SUDEP (Sudden Unexpected Death in Epilepsy). Women with epilepsy need specialized care regarding contraception and pregnancy due to medication interactions and potential effects on the fetus. Most people with epilepsy can lead normal, active lives with proper treatment, though psychosocial support is important to address the condition's emotional and social impacts.