Neurology in Germany

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 Germany?

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 Germany 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 Germany

About Germany

Germany, a titan in Central Europe and a vital constituent of the European Union, enjoys the reputation of having the finest healthcare system across the continent. Medical tourists often choose Germany due to its unrivaled service quality over cost, with Neurology procedures being the most in-demand.

Prices here exhibit a significant hike when compared to the neighboring countries of Poland and Hungary. Germany, despite housing just two JCI accredited facilities, places considerable trust in its local accreditation bodies.

This includes institutions such as the German Institute for Standardisation, the Telemedicine for the Mobile Society (TEMOS), and the Cooperation for Quality and Transparency in Healthcare (KTQ-GmBH). The language barrier is virtually non-existent as the majority of the doctors and medical staff exhibit proficiency in English. Beyond the capital city of Berlin, Munich, Hamburg, and Frankfurt are popular delectations among medical tourists.

Popular Parts of Germany

Home to an approximate 83 million inhabitants, Germany stands tall as the second most populated nation in Europe. The country presents a fascinating blend of deep-rooted history and cutting-edge technology. Visitors can pay their respects at numerous WWII memorials and museums, bask in the allure of the country's picturesque natural landscapes, or surrender to the tantalizing array of culinary delights that Germany has to offer. Truly, Germany embraces diverse interests, ensuring every traveller finds something to cherish.

• Berlin is Germany’s capital city. It is a vibrant city with diverse sights to see. Visit the glass dome of The Reichstag, take a walk through Brandenburg Gate, be inspired by Berlin Cathedral, or wander around a UNESCO World Heritage Site: Museumsinsel (Museum Island).
• Munich is home to a beautiful historic city center, futuristic drives, and outdoor fun. For a historical tour, tourists can travel to the Church of St. Peter, the city’s oldest parish church dating back six centuries. For a car lover, visit the BMW Museum to learn more about the history of BMW cars and motorcycles. For outdoor activity, tourists can surf at the Eisbach wave on the Isar river.
• Hamburg provides refreshing sea air. The city was labeled as “the gateway to the world” because it is a center of international trade. As the city revolves around water, tourists should stroll around the harbor, lay around beside the Elbe, or sail on the Outer Alster lake.
• Frankfurt am Main is the financial and business hotspot of Germany. Although it is packed with skyscrapers, the city still offers amazing architecture, a piece of history, and even a large green space in the city forest.
• Hanover calls itself as the “EXPO City” because it hosts several of the biggest exhibition in the world. The city also boasts an astonishing blend of modern and ancient. There are a number of museums and galleries, a large zoo, and innovative street art for tourists to explore.

Weather and Climate in Germany

The four distinct seasons make Germany a year-round destination for tourists. The summer starts in June and ends in August. The average temperature is 24 °C, sometimes even as high as 30 °C. People tend to enjoy outdoor activities during this season. This is also the most popular time to visit and peak travel season, so prices can be higher than usual.

Autumn graces Germany in the months of September and October. During this time, the weather is comfortably warm, closely mirroring that of summer. However, by mid-November, a notable drop in temperatures can be expected. This period is particularly popular among tourists owing to the much-celebrated Oktoberfest.

Winter in Germany, which runs from December through February, can be chilling with temperatures dropping to as low as -10°C. Yet, the festive vibrancy brought on by the Christmas season often offsets the cold. Visitors planning a trip during winter must ensure to pack ample warm clothing for a comfortable experience.

Spring in Germany marks the delightful bloom of cherry blossoms and typically spans from March through May. The transition into this season often ushers in a rapid rise in temperatures, making it a beautiful and warm period to visit.

Getting around in Germany

Frankfurt Airport is the largest airport in Germany. The airport serves domestic flights as well as international flights. It connects the country with almost every country in the world. The airport is the hub for Condor and Lufthansa. It also serves budget airlines such as Ryanair, Euro wings, Wizz Air. Düsseldorf International Airport and Munich Airport also receive their shares of international flights.

Train, bus, and taxi are the best options to get to the city center from Frankfurt Airport. A trip by train usually costs 4.65 EUR and takes around 40 minutes. Train tickets need to be punched, otherwise, you can get a 50 EUR fine. The bus costs 4.35 EUR and takes around 30 minutes. Buses that take tourists to the city center are No. 61, 77, 72, 58, 62, N81 and N7. Taxis are not very cheap, it will cost around 25 EUR and will take approximately 20 to 30 minutes to the city center.

As the creator of the first highway system, Germany has some of the best public transportation in the world. The public transportation is integrated with one ticket that gives tourists access to buses, trams, U-Bahn trains, and S-Bahn trains. A one-way fare starts from 2.90 EUR. It is better to get a one-day unlimited pass for 7 EUR or three days for 17 EUR.

Train travel is very efficient and affordable. Germany rail system has both high-speed trains and regular trains. High-speed trains are very fast but much more expensive. It’s advised to book train tickets in advance. Buses are the most cost-effective way to get around Germany although it is not as efficient as the train. Buses here are comfortable with air-conditioning and rest stops.

Taxis in Germany are expensive. All taxis are metered and start with a base fare of around 3.70 EUR. There is no Uber in the country, but tourists can use the MyTaxi App. If you want to get around the city, the best way is to rent a bicycle. Most cities are equipped with well-marked bicycle lanes.

Tourist Visas in Germany

Germany extends a cordial welcome to citizens from numerous nations, offering them visa-free entry. This privilege applies to travelers from Australia, New Zealand, Canada, Israel, Japan, Poland, the United States, and Switzerland, who are invited to stay for up to 90 days without the need for a visa.

Moreover, as a member of the European Union (EU), Germany adheres to the policy of open borders with its fellow EU nations. Consequently, EU citizens can freely travel to and enter Germany without any requirement for a visa. This ease of movement provides an added advantage for those wishing to visit Germany, whether for business, leisure, or medical purposes.

Citizens of other countries need a Schengen Visa. The application for a Schengen Visa must be filed with the embassy of the country of your primary destination. It is best to always check the requirements for Germany Visa Application before applying.

Additional Information

1. Local Currency: the local currency is the euro (EUR). 1 USD converts to 0.94 EUR.
2. Money & Payments: ATMs are easily available across the country. The easiest way to obtain cash is to use an ATM linked to international networks. Credit cards are not widely accepted in Germany, so always make sure to carry some cash. Some hotels, shops, and restaurants will accept credit cards. Tipping 1 EUR to room cleaners or porters is common. Most people add 5% or 10% tip in restaurants and bars. Tourists can tip about 10% to taxi drivers.
3. Local Language: The official language is German. It is nice to know a little German to show respect. Many Germans in major cities and tourist areas will know a little English.
4. Local Culture and Religion: 57% of Germany’s population follows Christianity, making it the largest religion in the country. Islam is the second largest religion. Buddhism, Judaism, Hinduism are also practiced.
5. Public Holidays: Germany celebrates Christian religious holidays. The country hosts several festivals such as Maibaumaufstellung every 1st May and Oktoberfest in October.