Neurology in Berlin

Neurology is a branch of medicine that focuses on the diagnosis and the treatment of diseases of the nervous system. The nervous system is a complex and sophisticated system that regulates and coordinates our body activities. It is divided into two major parts:

• The central nervous system: the brain and spinal cord
• The peripheral nervous system: all nerves branching out from the brain and spinal cord, and extend to other parts of the body, including organs and muscles.

Since the nervous system is complex, there are numerous subspecialties within the field of neurology, including:

• Neurodevelopmental disabilities
• Pediatric or child neurology
• Neuromuscular medicine
• Pain medicine
• Hospice and palliative care neurology
• Headache medicine
• Vascular Neurology (stroke care)
• Sleep medicine
• Autonomic disorders
• Brain injury medicine
• Neuropsychiatry
• Epilepsy
• Neurointensive care

A doctor who specializes in treating diseases of the nervous system is called a neurologist. Symptoms that often require a neurologist help may include coordination problems, muscle weakness, confusion, dizziness, and a change in sensation. People who are having problems with their senses, such as vision, touch, or smell, may also require to see a neurologist since problems with senses are sometimes caused by disorders of the nervous system.

A neurologist may also treat patients with:

• Stroke
• Seizure disorders, such as epilepsy
• Migraines and headaches
• Brain aneurysms
• Brain tumors
• Peripheral neuropathy
• Multiple sclerosis
• Infections of the nervous systems, such as meningitis, encephalitis, or brain abscesses
• Neuromuscular disorders, such as myasthenia gravis
• Neurodegenerative disorders, such as Alzheimer’s disease and Lou Gehrig’s disease
• Sleep disorders
• Spinal cord disorders, such as autoimmune and inflammatory disorders
• Speech and language disorders

Keep in mind that neurologist does not perform surgery. If you need surgery, you will be referred to a neurosurgeon.

What does Neurology Involve?

A wide variety of different tests and procedures are used to diagnose and treat neurological conditions. On your first appointment with a neurologist, a physical and neurological exam is likely to be performed. A neurological exam is done to test muscle strength, coordination, and reflexes.

Because different diseases can have similar symptoms, more than one testing may be required for your neurologist to make a diagnosis.

Some of the procedures that fall into the field of neurology may include:

Electromyography

Electromyography (EMG) is used to measure how well your muscles react to electrical stimulation from motor neurons, which are specific nerves controlling muscle movement. It can help neurologists diagnose general muscle or nerve dysfunction, as well as spinal cord disease.

During an EMG, small needles called electrodes are inserted into the muscle by a specially trained technician. The electrodes can measure the different electrical activity occurring in muscle tissue during periods of movement and rest.

Electroencephalogram

Electroencephalogram (EEG) is performed to assess and record electrical activity in your brain. Neurons in our brain communicate with other neurons through electrical impulses, which an EEG can record. Brain wave patterns can also be tracked by an EEG. It is used to help diagnose conditions of the brain, including tumors, inflammation, injuries, as well as psychiatric disorders, epilepsy, and seizures.

During an EEG, electrodes are placed on your head. The electrodes are connected to a computer, which converts electrical signals into patterns that can be seen from a screen or printed on a piece of paper.

Lumbar puncture

Lumbar puncture is done to test your spinal fluid. It involves inserting a needle into your spine after numbing it with an anesthetic. Using the needle, a sample of your spinal fluid is taken.

A lumbar puncture can help diagnose the following conditions:

• Meningitis
• Encephalitis
• Leukemia
• Myelitis
• Dementia
• Autoimmune diseases, such as multiple sclerosis (MS)
• Bleeding in the brain

The procedure can also be used to treat conditions affecting the spinal cord. Your neurologist may inject anesthetics, cancer treatments, or antibiotics using a lumbar puncture needle.

Tensilon test

To help diagnose myasthenia gravis, your neurologist may perform a tensilon test. It involves the injection of a medicine called Tensilon. Then, your neurologist observes how medicine affects your muscle movements.

Sleep study

Chronic sleep problems are diagnosed in a Sleep Study. Also known as a Polysomnogram (PSG), this procedure involves monitoring patients during sleep and physiological data is recorded electronically.

Other tests

Other types of tests may be used by your neurologist to make a diagnosis. These may include:

• Magnetic resonance imaging (MRI scan)
• Computed tomography (CT scan)
• Positron emission tomography (PET scan)
• Biopsy
• Genetic testing
• Angiography

Botox injections

Botox injections can be done to treat some neurological conditions, such as cerebral palsy, that can cause your limbs to pull in toward your center. Sometimes, these contracted muscles can be relaxed with Botox injections.

Botox injections involve injecting tiny amounts of botulinum toxin into your skin of muscles using a thin needle.

Brain tumor treatment

A range of treatments can be done to treat a brain tumor. If your neurologist believes that you need surgery, you will be referred to a neurosurgeon who will remove as much of the brain tumor as possible through surgery.

A brain tumor may also be treated with radiation therapy, which uses high-energy beams to kill tumor cells.

Brain tumor treatment may be integrated between the departments of neurology and oncology.

Brain rehabilitation therapy

Brain rehabilitation therapy is used to help you relearn functions that are lost as a result of a brain injury. Brain rehabilitation therapy is usually integrated between specialty teams in the departments of neurology, sports medicine, psychiatry and psychology, neuroradiology, and the vestibular/balance laboratory.

Deep brain stimulation

During deep brain stimulation, electrodes are implanted within certain areas of the brain. The electrodes generate electrical impulses that can regulate abnormal impulses. These electrical impulses may also affect certain chemicals and cells within the brain.

Deep brain stimulation can be done to treat numerous conditions, including dystonia, essential tremor, epilepsy, and Parkinson’s disease. It is also being studied as a potential treatment for multiple sclerosis and stroke recovery.

Spinal stenosis treatment

Spinal stenosis is a condition that occurs when the spinal canal narrows and pinches the nerves, leading to back and leg pain. Spinal stenosis may be treated with pain medications, physical therapy, steroid injections, decompression procedure, or surgery. Surgery is usually performed if other treatments have not helped.

How Long Should I Stay in Berlin?

Your length of stay depends on the type of procedure you have, you may be allowed to leave the hospital on the same day or you will stay for several days. For diagnostic procedures, you should be allowed to leave the hospital on the same day. However, you should wait until the results of the test are ready before you can fly home, which may take as long as 7 days, sometimes even longer. If you undergo brain tumor treatments or other types of treatment, especially treatments that involve surgical intervention, you should aim to stay in Berlin at least for 10 days.

What's the Recovery Time?

The recovery time can be different for each procedure. It may also depend on the reason why you are having the procedure and your overall health. Your neurologist and neurosurgeon will give you a recovery timeline for each procedure. The recovery period for diagnostic procedures is typically short and you may be able to resume your normal activities within a week or so. For surgical procedures, you may need to wait 4 weeks or months until you can go back to your daily routine, including work and exercise.

What About Aftercare?

A detailed aftercare instruction will be given to you following your procedure. While the instructions will be different for each procedure, they typically include a diet plan, exercise, restrictions, and wound care (if any surgical intervention is involved). You should follow these instructions carefully in order to have a speedy and smooth recovery.

You may also need to attend follow-up checkups to monitor your overall condition and healing. For brain tumors, you may need to attend regular checkups to ensure the tumor has not come back.

What's the Success Rate?

The field of neurology is constantly advancing. The success rate of each procedure is typically high, particularly when performed by highly skilled and experienced medical professionals. Still, some procedures may carry some risks, such as bleeding, infection, and nerve injury.

Are there Alternatives to Neurology?

Since neurology is the branch of medicine to diagnose and treat problems of the nervous system, there are no other alternatives. However, if your doctor found that your disease or illness is found to be caused by other problems unrelated to the nervous system, your doctor will recommend you to see the relevant doctor.

Neurology in and around Berlin

About Berlin

Berlin is the capital and the largest city of Germany and with over 3.7 million inhabitants; it is the second-most populous city of the European Union after London. It is an alpha city of culture, politics, media, and science. The metropolitan city is also a popular tourist destination, thanks to its rich history, vibrant culture, lively parties, delightful food, and incredible architecture.  

Today, Berlin is one of the most popular destinations for medical tourism. The number of medical tourists coming to the city increases each year. Most of them travel from Poland, the Netherlands, France, and the Middle East. Some of the more popular treatments are oncology, cardiology, dentistry, and even tummy tuck. Although the cost is considerably higher than the neighboring countries such as Hungary, medical tourists still come for high-quality treatment with cutting-edge technology. Thousands of medical tourists prefer Berlin for the following reason:

• A patient-focused health-care system with a wide range of treatment.
• Qualified doctors, surgeons, nurses, and other medical practitioners. 
• Hospitals equipped with modern technology.
• Higher quality treatments, care, and services.
• Attractive destination and environment, perfect for rejuvenating and recovery.

Popular Areas in Berlin

As a famous tourist destination, Berlin has numerous attractions to see and many things to do. Whether you want to indulge in its culture, eat its food, or have a non-stop party, there will always be something for you.

• Museum Island (Museumsinsel) is a UNESCO World Heritage Site. It is a unique group of five world-renowned museums and it is the perfect place for those who love history and culture. From Ancient Egyptians, Roman Antiquity, the civilizations of the ancient Greek, Christian, and Islamic arts, to 19th Century European Art is available to see in the museums. 
• Brandenburg Gate is Berlin’s most famous landmark. This 18th-century neoclassical monument used to symbolize divided Germany during the cold war since the Berlin Wall shut off access to the gate for both East and West Germans. Now, it has turned into a symbol of unity.
• Berlin Wall Memorial is located in the middle of the city where East and West were once divided. The memorial extends along 1.4 kilometers of the former border strip and contains the last piece of the Berlin Wall. The historical remnants and traces of borders are preserved on display so visitors can see and learn more about the history behind it. 
• Berlin Cathedral (Berliner Dom) is the biggest church building in Berlin. The architecture and interior will leave visitors in awe. The architect, Julius Raschdorff, used the style of the Italian High Renaissance and Baroque elements. The interior is magnificent with marble columns and golden ornaments in abundance.
• Glass Dome of the Reichstag is an architectural masterpiece constructed on top of the rebuilt Reichstag building. The rooftop terrace and dome offer an outstanding view of the parliamentary and government district as well as Berlin’s skyline. There is also a restaurant on the rooftop.

Weather and Climate in Berlin 

Just like the rest of Germany, Berlin enjoys four distinct seasons, making it a year-round destination for tourists. Spring starts around March and ends in May. This season is characterized by the arrival of cherry blossoms and the increase of the temperature. The temperature is around 4.3 °C in early March and will get as warm as 19.4 °C in May.

Summer runs from June to August with an average temperature of 24 °C but can get as high as 30 °C in the hottest days. This season is the peak of tourism because people can enjoy outdoor activities, so prices can be a lot higher than usual.

The months of September and November are Autumn. The weather in this season is similar to summer, which is warm and pleasant. However, the temperature can drop significantly in late November. Tourists usually visit the city during autumn for the Oktoberfest.

Winter in the city can be freezing, cloudy, and wet. The temperature can plummet to -10 °C on the coldest days. The city is generally very festive during this season, thanks to the Christmas spirit. 

Getting Around in Berlin

Berlin has two main airports: Berlin Tegel Airport and Berlin Schönefeld Airport. The main international airport is the Berlin Tegel Airport located in the northwest. The airport serves domestic flights to other cities in Germany and international flights to almost every major city around the globe. Berlin Schönefeld Airport is the secondary airport that mainly serves budget airlines such as EasyJet and Ryanair. It is also an international airport that operates domestic and international flights. To get to the city center from both airport, bus, train, taxi or car are available. 

To get around Berlin, there are various transportation modes to choose from. The main means of transport in the capital is the U-Bahn system, which comprises 9 metro lines and 173 stations. During peak hours, trains run every two to five minutes and every ten minutes in the evening and on Sundays. Along with the U-Bahn, the S-Bahn system is also one of the main means of transport. It has 15 lines serving 166 stations and has a longer average distance between station than the U-Bahn. 

Tourists can also ride the tram and the tram lines mostly operate in the eastern neighborhoods since the tram lines in the former West Berlin were replaced by bus and U-Bahn. The tram lines operate 24 hours a day in some areas. 

The bus in Berlin has around 151 lines running every 10 minutes for 24 hours. The buses also replace metro trains during closing hours. Taxis can be found easily enough around the city, with more than 7,000 taxicabs. The taxis can be identified by the beige or ivory color. The base fare is 3.90 EUR and tourists can hail the taxis from the street, by phone, or via an app. Other transportation such as Ferry, car sharing, and e-scooter is also available.

Tourist Visas in Berlin

The citizens of Australia, Canada, Israel, Japan, New Zealand, Poland, the United States, and Switzerland can enter and stay in Berlin for up to 90 days. Since Germany is a member of the European Union, citizens from other European Union countries do not need to obtain a visa to enter. Citizens of other countries need a Schengen Visa. It is advisable to always check the requirements for Germany Visa Application before applying.

Additional Information

1. Local Currency: The official currency is the euro (EUR). 1 USD is equivalent to 0.81 EUR.
2. Money & Payments: Tourists can find ATMs almost everywhere within the city. Although credit card acceptance is growing, remember that cash is king in the city. Therefore, it is best to always carry some cash. Note that it is considered rude to leave a tip on the table. You should tell the server the total amount you want to pay. For a good restaurant service, a 10% tip is acceptable. For taxis, tourists can tip 10%, rounding to a full euro.
3. Local Language: German is the official language. Most people in the city will speak English, in hotels, restaurants, and shops.
4. Local Culture and Religion: Over 60% of Berlin’s population has no religious affiliation, while 30% identified as Christian.
5. Public Holidays: As most of German, Berlin celebrates major Christian religious holidays such as Easter and Christmas.