Neurology in India

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 India?

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 India 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 India

About India

As the largest country in South Asia and the seventh-largest in the world, India is home to over one billion inhabitants. This extremely diverse country boasts one of the world’s fastest-growing economies and with its 38 JCI accredited facilities, it’s considered a prime destination for Medical Tourism. India welcomes an ever-increasing number of medical tourists each year, many of which travel for Neurology procedures. Its low-cost medical procedures draw tourists from all over the world, particularly Western and Middle Eastern countries. Highly specialized doctors speak English and the vast majority are trained in the UK or the US, with heart surgery procedures being especially common in India. Local accreditation bodies include the Indian Healthcare Federation, the Indian Medical Tourism Council, the Ministry of Health and Family Welfare, and the National Accreditation Board for Hospitals & Healthcare Providers (NABH)

Popular Parts of India

Home to around 1.3 billion people, India is the second-most populous country in the world, with its multi-ethnic society, spiritual beliefs, architecture, and diverse wildlife.

• Delhi is brimming with colorful modern life and is steeped in history. It is known to have the best food in the world such as Mughalai curries and chaat (vegetarian street food). Visit the Red Fort and witness the fascinating structure influenced by Islamic, Hindu, Persian, and Timurid traditions.
• Mumbai is the most cosmopolitan city in India. Home to Bollywood, India’s film industry, the city has a lot to offer. Stroll around the Gateway of India, shop in Colaba Causeway, watch the sunset in Marine drive, or visit Siddhivinayak Temple and learn about its cultural history.
• Kolkata (Calcutta) was once the capital city of India. It is a perfect blend of the past and the present. The city has charming colonial-era architecture, dynamic suburbs, and the amazing Bengali cuisine. Tourists can discover the creativity of Kurmatuli Idol-makers and visit the incredible Victoria Memorial.
• Jaipur is known as “The Pink City,” it is chaotic, vibrant, and historical.  The city, along with Delhi and Agra, is a part of the Golden Triangle that contains the biggest attractions in India. There are many beautiful buildings inside this city, but the most visited one is the Amer/Amber Fort that dates back to Raja Man Singh. It is a World Heritage Site and it offers amazing views of the city.
• Agra is where the magical Taj Mahal stands. The UNESCO World Heritage Site is as astounding as people describe it to be. Mehtab Bagh is another must-visit attraction; it offers the most scenic spot in the city and located just across the river from the Taj Mahal. Agra Fort, located northwest of the Taj, is one of India’s most historic structures.

Weather and Climate in India

There are four climatological seasons in India.

• Summer or pre-monsoon season starts in March and ends in May. April or May is the hottest month. The average temperature is around 23 to 42 °C.  
• Monsoon or rainy season lasts for three months from June to September. The season is usually humid and rainy. South India usually receives more rainfall.
• The post-monsoon or autumn season starts from October to November. The sky is usually cloudless.
• Winter occurs from December to February. December and January are the coldest months in the country with an average temperature of 10 to 15 °C and climb steadily from February. This is the peak season for tourism.

The best time to visit India is in the month of March or October when the weather is warm and sunny.

Getting Around in India

Indira Gandhi International Airport is the busiest airport in the country and is located in Delhi. The airport serves domestic and international flights. It connects the city with almost every country around the world and serves budget airlines such as Air Asia India, Go Air, and IndiGo. There are three other main international airports in Mumbai, Chennai, and Bengaluru.

The most affordable way to travel around the city is by bus although it can be very crowded. Buses are very reliable and fast. Airport taxis are available as a quick, easy, and hassle-free transportation mode especially for tourists who carry big baggage.

The best way to get around India is by train. Trains are everywhere and quite affordable with many different classes. The most popular class for travel is the Sleeper Class. It is best to purchase train tickets online.

Buses are a nice option for short-distance travel. Some of the buses can be very uncomfortable but there are luxury buses with air conditioning. Tourists can purchase tickets online, in the station, or even on the buses.

Taxis are relatively affordable, but tourists have to bargain. Tourists can ask the taxi driver to use the meter but the drivers will usually say it’s broken. It is advised to ask your hotel or hostel how much a taxi should cost before getting in one to avoid getting ripped off by taxi drivers. Rickshaws (Tuck-Tuks) are cheaper than taxis, but you also have to bargain. Hiring a car is not recommended due to the lack of respect for traffic laws and the chaos on the roads. Uber is available.

Tourist Visas in India

All visitors need to obtain and apply for a visa to enter India, except the citizens of Nepal and Bhutan. Visa on Arrival is available for citizens of Japan and South Korea. The country provides an online visa application. e-Visa is available for 150 nationalities and valid for  60 days. It is a double-entry visa. There is also a six-month tourist visa for longer trips.

Passport must be valid for at least 180 days after your entry to India and should have at least two blank pages.

Additional Information

1. Local Currency: the official currency is the Indian rupee (INR). 1 USD is equivalent to 70 INR.
2. Money & Payments: ATMs are widely available. Currencies such as US dollars, euros, and pounds sterling are easy to change throughout the country. Credit and debit cards are accepted in some shops, restaurants, and hotels. Always carry cash because many places still accept cash only. Service fees are sometimes added to the bills automatically in restaurants if it’ 10% tip is reasonable. Taxis and rickshaws do not expect a tip but it is good to tip drivers who are honest.
3. Local Language: There are many languages spoken in India including Hindi, Bengali, Telugu, Marathi, Tamil, Urdu, Gujarati, and Punjabi. English is understood by many people especially those in the tourism area and major cities.
4. Local Culture and Religion: India is very diverse and multicultural. Hinduism is the largest religion with 79.8% of the population practicing the religion. Islam, Christianity, Sikhism, and other religions are also practiced.
5. Public Holidays: India celebrates several major religious holidays. The country has numerous annual festivals such as Holi, Ganesh Festival, Diwali, and Onam.