Kensington NeuroBlog 1 : What is Neurology? Asks Dr Mark Weatherall Consultant Neurologist
The word ‘neurology’ was invented by the 17th century physician Thomas Willis (1621-75). Willis needed a term to describe the anatomical study of the brain and the nervous system, something that he pioneered in the years during, and after the English Civil War. The term caught on, and is used to this day to denote both the study of the brain and nervous system, and the medical speciality whose practitioners are experts on it. Neurology encompasses both the central nervous system (CNS), that is, the brain, spinal cord, spinal nerve roots, cerebrospinal fluid, and so on; and the peripheral nervous system (PNS), that is, the nerves and muscles controlled by the brain and the CNS. Some of the more common neurological conditions include migraine, dementia, stroke, epilepsy, multiple sclerosis, and Parkinson’s disease.
According to the Neurological Alliance, over 10 million people in the United Kingdom have a neurological condition that impacts significantly upon their lives, of whom over 1 million are disabled by their condition, and 350,00 require help to carry out the usual activities of daily living. 10% of visits to A&E are due to a neurological problem, as well as 17% of GP consultations, and 20% of hospital admissions.
The medical speciality of neurology has always been a fairly small scale affair in the United Kingdom. The historian Stephen Caspar’s book The Neurologists details the early development of the speciality from its origins in London – specifically the National Hospital for Diseases of the Nervous System including Paralysis and Epilepsy, founded in 1859, and now known as the National Hospital for Neurology and Neurosurgery, Queen Square – to its post-war expansion into District General Hospitals across the United Kingdom. The last 20 years has seen another expansion in the numbers of neurologists, from 1:200 000 in the mid-1990s, to 1:115 000 in recent years, but there are still far fewer neurologists per head in the UK compared with other European countries (there are 1:26 000 in the Netherlands, for example), and coverage is patchy, being better in London, and noticeably worse in Wales and Northern Ireland.
It follows that in the UK many patients with neurological conditions do not see a specialist. Many GPs do excellent work for their patients, but anything that contributes to the spread of accurate information on neurological conditions has the potential to benefit patients, their carers, and society as a whole. In coming weeks this blog will present information on neurological symptoms, investigations, diseases, and treatments. Feedback, and ideas for future topics, will be most welcome.
By Dr Mark Weatherall Consultant Neurologist