Neurology in Cape Town

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 Cape Town?

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 Cape Town 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 Cape Town

About Cape Town

Cape Town is the legislative capital of South Africa and is also known as the Mother City. It is the oldest city in the country and home to the Parliament of South Africa and is a major destination for immigrants and expatriates, making it one of the most multicultural cities in the world. Located on the shore of Table Bay, the city is known for its harbor, natural setting, as well as famous attractions and many tourists,  visit to enjoy Table Mountain and Cape Point. 

Recently, tourists also come to the city for its medical tourism. Many groundbreaking procedures and medical research in South Africa, such as the world’s first penile transplant, have put Cape Town under the radar of medical tourists from all around the globe. Thanks to its world-class healthcare and world-renowned medical practitioners, more and more people now prefer Cape Town as their medical destination. The healthcare in the city is among the best on the African continent. Other reasons such as shorter waiting times for surgeries, state-of-the-art equipment, and affordable healthcare compared to Europe and the United States, and English-speaking doctors. 

Popular Areas in Cape Town

Cape Town is a natural beauty that offers a wide range of things to do and see. From culture, food, art, to nature. Listed below are some of the more popular places in the city: 

• Table Mountain is one of the New 7 Wonders of Nature and it is easy to see why. The iconic mountain makes an amazing backdrop to Cape Town. The level plateau is about 3 kilometers from side to side with remarkable cliffs on the edges. The peak offers an amazing view of the city. Tourists can choose to board the cable car or discover its beautiful nature by hiking.
• Cape of Good Hope is situated within the Table Mountain National Park. The area has a mix of bio-diversity and wonderful beauty that attracts thousands of tourists to visit. There are around 250 species of birds spotted in the area. Hiking and cycling through it is the best way to discover its true majesty. Tourists can picnic and birdwatch in isolated beaches. 
• Kirstenbosch National Botanical Garden is one of the most incredible botanic gardens in the world. Nestled at the eastern foot of Table Mountain, it features a natural forest and fynbos flora and sprawls around 528 hectares. The garden displays a collection of diverse South African plants with seasonal festivals such as musical sunset concerts during summer and craft markets on the last Sunday of every month. 
• Groot Constantia is the oldest wine-producing estate in South Africa, located in the suburb of Constantia. The estate consists of a museum, restaurants, tasting room, and cellars. The museum was built in Cape Dutch architecture style, further into the estate; tourists will find the free orientation center which provides an overview of Groot Constantia history. Tourists can also tour the original wine cellar, have a wine tasting, or a wine and chocolate pairing.
• Boulders Penguin Colony is located in Boulder Beach on the outskirts of Simon’s Town. The beach boasts fine white sand with pristine waters and endangered African penguin colonies. Tourists can set up camp, see the penguins up close, and even swim along with the magnificent aquatic birds. Observing the penguins socializing and playing in the waves is a perfect way to enjoy your travel in Cape Town. 

Weather and Climate in Cape Town

Cape Town enjoys a warm Mediterranean climate. The summer is dry and warm, lasting from early December to March. The average maximum temperature during this season is around 26 °C, and the minimum is 16 °C. The Berg Wind that arrives from February to early March can make the city uncomfortably hot for a couple of weeks. 

The winter starts in June and ends in August and the season is characterized by mild and wet weather. The city also experiences strong north-westerly winds during this season. The average temperature ranges between 8.5 °C at the lowest and 18 °C at the highest. 

Getting Around in Cape Town

The primary airport that serves Cape Town is the Cape Town International Airport and it is the second busiest airport in South Africa and the fifth busiest in Africa. The airport serves direct domestic flights to major cities and several small centers in the country. It also connects the country with major cities in Africa, Europe, the Middle East, and Asia. It is the hub for South African Express as well as budget airlines such as Mango and FlySafair.

There are several types of taxis: the metered taxis, Rikkis Taxis, and minibus taxis. The metered taxis can be a little expensive but are usually comfortable. Tourists can order one via a phone call or from one of the city’s official taxi stands. Tourists should always choose reputable taxi companies such as Marine Taxi, Unicab, Excite, and SA Cab. 

Rikkis Taxis are painted yellow and very popular and these taxis run on a fixed fare rather than metered, so they are a little more affordable than metered taxis and a good option if you are traveling on longer journeys. Other than the Rikkis Taxis, tourists can choose the minibus taxis which are perfect for adventurous foreign travelers. The minibus taxis can be found practically everywhere and are very cheap, however, you will need to know exactly where your destination is and tell the driver when to stop. Another travel option is the MyCiTi bus, a modernized and effective bus system.

Tourist Visas in Cape Town

There are more than 60 countries listed in the visa exemption agreements, which means the citizens of these countries can stay in South Africa for up to 90 days. Other countries not listed must obtain a valid visa to enter the country. A Medical Treatment Visa is available for medical tourists. Note that all visitors must hold a passport valid for at least 30 days after the expiration of their intended visit.

Additional Information

1. Local Currency: South African Rand (ZAR) is the official currency and 1 USD converts to 14 ZAR.
2. Money & Payments: Tourists can find ATMs almost everywhere around the city, but you should avoid ATMs in secluded places, especially at night. Credit cards are accepted in established restaurants, hotels, and shops. It is always better to carry some cash because smaller food places are cash-only. Tipping is expected here.
3. Local Language: The most common languages in the city are English, Afrikaans, and Xhosa with Afrikaans as the most widely spoken home language.
4. Local Culture and Religion: The population follows Christianity, Islam, Judaism, and several other religions.
5. Public Holidays: There are 12 official public holidays in Cape Town, including New Year’s Day, Freedom Day, and Christmas.