Neurology

The Medical Chambers Kensington is home to Dr Mark Weatherall PhD FRCP Edin, one of the UK's foremost Neurologists. His Specialty is particularly complex, so we asked him to write a concise "What You Need To Know About Neurology" for us. Here it is.


Neurology deals with diseases of the brain, nerves and muscles. Neurologists deal with all sorts of common and rare diseases, both non-threatening (benign) and serious. If you suffer from headaches, blackouts, tingling or numbness in your body, weakness, tremor, dizziness or difficulties with memory, you might need to see a Neurologist. Here is some information about the most common symptoms.

 

Headaches  Headaches are very common. Many people worry that their headaches indicate a serious problem with the brain, but in the vast majority of cases the problem is simply migraine or tension-type headaches. Neurologists can diagnose most headaches from a simple history and examination, though sometimes an MRI scan can be useful. Just occasionally further tests might be necessary although this is very unusual. There are many treatments which can be helpful, from simple adjustments in lifestyle, to medications, nerve blocks, or even injections of Botox. A sudden severe (worst ever) headache is a worrying symptom and you should go to hospital straight away if you get one.

Mark is often interviewed by the media and here he is talking about migraine on BBC Radio 4.

 

Blackouts  Many of us will pass out in our lives. Most of the time, this is a simple faint, causing nothing more than temporary loss of consciousness and, possibly, rather longer lasting embarrassment! Rarely, people pass out repeatedly and if you do, you should see a Neurologist. The good news is that this is very commonly a blood pressure problem, but sometimes it can be the result of problems with your heart rate or rhythm (rare in the young, but common in the elderly) or with the electrical activity of your brain (epilepsy, which is comparatively rare). It is important that you keep a note of your blackout history not only as you experience it but as witnessed by others around you. 

 

Numbness or Tingling  Most of us experience occasional odd disturbances in sensation. This is normal, but if you experience persistent numbness, tingling, burning discomfort in your face, arms or legs, then you should get these symptoms checked out. It is common to find trapped nerves at the wrist (carpal tunnel), elbow and knee. These usually settle down by themselves if simple precautions are taken to prevent pressure on the nerves; rarely, a small operation is necessary to solve the problem. It is also common for people to get trapped nerves in the neck, or lower back, again causing pain, numbness and even weakness in the limbs. Simple clinical examination, backed up by electrical tests of the nerves and sometimes scans of the neck or lower back, can usually resolve these problems and guide your Neurologist to the appropriate treatment.

 

Weakness  Sudden weakness of the face or limbs can be a serious symptom, indicating a possible stroke, and you should go to hospital immediately if this happens to you. Weakness coming on more gradually can be a problem with the brain, spine, nerves or the muscles themselves. Again, it is important to make a detailed history available to your Neurologist and examination will usually suggest an answer.

 

Dizziness  This can mean lots of different things. It can mean light headedness often due to low blood pressure. It can mean a sense of the world moving around you or you moving when you know you are not. This is vertigo, most commonly due to a problem with the inner ear, but just occasionally due to a neurological problem such as migraine. Yet again, a good history followed by examination will often suggest the most likely cause and tell your Neurologist which tests you need. Some causes of dizziness, such as benign positional vertigo, can often be cured at your bedside by specific manoeuvres.

 

Tremor  Tremor, shaking of your limbs during movement, at rest or in other circumstances such as writing, is common. Most tremors are benign and no more than an irritation or an embarrassment, but certain tremors can be caused by medical problems such as an overactive thyroid gland or vitamin deficiencies. Simple blood tests can often help uncover these problems and lead to treatment. A different type of tremor is seen in conditions such as Parkinson's Disease. There are good treatments for most tremors and for most cases of Parkinsons Disease.

 

Memory Problems  We are all forgetful from time to time particularly if stressed, tired, depressed, anxious or short of sleep. Significant memory problems are extremely rare in people under 50. Bedside testing can often give a clear idea of whether memory problems are part of what you might expect in every day life or whether there is a more serious problem which requires looking at. 

So don't worry.........your Neurologist can diagnose and manage many conditions. Some, like migraine are common and usually simple to manage. Others, like Multiple Sclerosis and Parkinson's Disease are fortunately rare. People often worry that they might have one of these long-lasting (chronic) neurological conditions, but if you do try not to worry because they are so rare. Getting an accurate, early diagnosis is very important because there are many new and potentially effective treatments available and becoming available.

 

Here are some links which may help you.

The Migraine Trust

Migraine Action

OUCH(UK)