Neurology in Israel

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 Israel?

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 Israel 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 Israel

About Israel

Israel celebrated 70 years of independence in 2018 - in what is a truly ancient land. The world’s only Jewish and democratic state is home to sites sacred to Judaism, Christianity, and Islam. While these holy places are truly unique attractions, there is more to Israel than religious heritage and complex politics. Jerusalem is the official capital and holy city to three world religions, previously mentioned, while Tel Aviv brims with beaches and bustles with urban vitality. Then there’s the Dead Sea and Masada, the stark, stunning Negev, and fertile Galilee. The number of museums and cultural institutions per relative area is larger in Israel than anywhere in the world.

Home to more than 30 JCI accredited facilities, medical tourists visit Israel for a variety of procedures, but particularly dental and tertiary care. Neurology procedures are also a popular choice.

Popular Parts of Israel

Israel is an alluring destination for those who want to appreciate its astonishing religious sites, stunning natural beauty, and remarkable historic relics. 

• Tel Aviv is the economic and technological center of Israel, with a population of over 400,000; it is the most populous city in the country. Located on the Mediterranean coastline, the city offers sunny beaches for any sun-chaser. The city has impressive architecture and has a modern cosmopolitan landscape. Tel Aviv Museum of Art houses works by international artists. In addition, it has a nonstop nightlife with a huge party option to fit every taste.
• Haifa is the country’s third-largest city and it is one of Israel’s high-technology centers as well as a busy working port. The city may have an industrious image, but with a number of museums, gardens, and shrines, it is an amazing place to travel to. The Baha’i Gardens are possibly the most popular attraction as it is the final resting place of the prophet-herald of the Baha’i Faith. Tourists can have a bird’s eye view from the platform at the top or take a free Panorama Tour.
• Eilat is located at the southernmost tip of Israel and is the only Israeli city on the Red Sea. Families come to the city to have a good time on the beach and party-goers come for its all-night parties. The turquoise waters invite visitors to snorkel, scuba dive, or swim. It is recommended to stay in an Oasis at night to get a chance to stargaze under a clear desert night sky. During the day, visit the Eilat Mountains to have a beautiful view of an ancient desert.
• Tsfat or Safed is a quaint mountain-top city surrounded by pine forests. Located at an elevation of 900 meters, the city enjoys warm summers and cold winters. It is a popular summer holiday resort frequented by Israelis and foreign visitors. Here, tourists will find synagogues, art galleries, and unique crumbling stone houses.
• Jerusalem is one of the oldest cities in the world and three major Abrahamic religions (Judaism, Islam, and Christianity) considered it a holy city. Even though it has been destroyed and rebuilt over thousands of years, the city manages to endure its spiritual magnetism. It is overflowing with holy sites, diversity, and layers of history.

Weather and Climate in Israel

Israel is a year-round destination but the temperatures in the city vary widely. The coastal areas such as Tel Aviv and Haifa experiences a typical Mediterranean climate where the winters are rainy and the summers are hot. The area around Northern Negev has a semi-arid climate with hot summers and cool winters. The Southern Negev has a desert climate with extremely hot summers and mild winters. On the other hand, mountainous regions have pleasant summer and cold winters with a little snowfall.

Generally, the winter months from November to March are the coldest months in the country. When mountainous areas such as Jerusalem receives snowfall, the coastal areas experience heavy rainfall. Summer starts in June and ends in August and it is the hottest season in every part of the country, especially in the desert area where the heat can be overbearing. The seasons of spring and autumn have the best weather, with pleasant temperatures and fewer rainy days.

Getting Around in Israel

Ben Gurion Airport is the main gateway to Israel and it is the busiest airport in the country located 20 kilometers southeast of Tel Aviv and 45 kilometers northwest of Jerusalem. The airport is ranked among the five best airports in the Middle East. It serves both domestic and international flights to and from numerous major cities around the world. There is two main passenger terminal at this airport. Terminal 1 serves domestic flights and international budget airlines such as EasyJet and Vueling, while Terminal 3 serves international flights. 

Since the distance between one city to another is relatively short, getting around Israel is easy. The quickest and most convenient way is by domestic flights. The tickets are not very expensive and deals are often available online. Sometimes a one-way ticket can cost as little as 89 NIS (25 USD). Buses are also convenient but can be slow during traffic jams. Buses connecting Jerusalem, Tel Aviv, and Haifa depart very frequently. A one-way ticket from Tel Aviv to Jerusalem is around 25 NIS (7 USD). Israel’s main bus company is the Egged Bus Company. Trains are also available and very comfortable. They are a lot faster than the bus but the cost can be higher.

Taxis are widely available and can be hailed directly from the streets. Although most taxis are metered, you can agree on a fixed rate and be aware that some drivers are known to overcharge tourists, so you should insist on using the meter and make sure that it is reset to the base fare after you get in. The base fare is normally around 12.30 NIS (3.5 USD). There is also a shared taxi van known as Sherut. It is a good option to travel between Tel Aviv and Jerusalem or Tel Aviv and Haifa.   

Tourist Visas in Israel

All visitors must hold a passport valid for at least six months after the date of departure from Israel. Citizens of 99 countries including the European Union, Canada, Singapore, Russia, and the United States do not require a visa to enter the country for up to 3 months. Nationals not listed on the visa exemption agreement need to obtain a visa and should contact their nearest embassy of Israel. Citizens of 25 countries require a confirmation from the Israeli government before a tourist visa is issued.

Additional Information

1. Local Currency: The currency is the New Israeli Shekel (NIS) and 1 USD will get you 3.28 NIS.
2. Money & Payments: ATMs that accept international cards are widespread (mostly Visa and MasterCard), except at border crossings with Egypt and Jordan. Credit cards are widely accepted and tipping is common but normally not expected. 
3. Local Language: The official language is Hebrew and Arabic has a special status under Israeli law as a semi-official language. Russian is spoken by around 20% of the population. Most of the population can speak English fairly well as it is required in schools and universities.
4. Local Culture and Religion: More than 70% of the population follows Judaism. There are small groups of Muslims, Christian, and Druze. Muslims are the largest minority group in the country.
5. Public Holidays: The country celebrates major national holidays as well as Jewish holidays such as Independence Day, Jerusalem Day, and Hanukkah.