Neurology in Italy

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 Italy?

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 Italy 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 Italy

Italy, a country in south-central Europe, boasts some of the most varied and picturesque landscapes in the world with the greatest collection of art treasures. The mere mention of Italy conjures up images of ancient Roman ruins, leaning tower of Pisa, stunning isles, rolling vineyards, and authentic cuisines. Besides its charming landscape, delicious food, and historical monuments, Italy is a popular spot for foreign patients to receive medical treatments. Its reputation for cutting-edge, high-quality treatment is growing rapidly. Although it is not the cheapest medical tourism destination, it is known for its highly qualified doctors and surgeons, as well as medical facilities that are equipped with the latest medical technology. Cosmetic surgery, hair transplant treatment, cosmetic dentistry, and cancer treatment are among the most popular treatments in the country.

Popular Parts of Italy

Rome, the capital of Italy, is the birthplace of Julius Caesar and is filled with Roman ruins, such as the Colosseum, Pantheon, and Forum. It is also home to Vatican City, the beautiful Sistine Chapel, the romantic Trevi Fountain, and picturesque restaurants filled with great food. Venice, another popular city in the country, is famous for its canals, gondola rides, and St. Mark's Basilica. On the west coast of Italy, visitors can find the Cinque Terre, which consists of five dramatically located hamlets. It is dotted with steep vineyards, mountains, and beautiful beaches. The fashion capital of Italy is Milan, the ancient towns of Pompeii, Naples, and stunning Florence with its Renaissance art are also popular tourist destinations. 

Weather and Climate in Italy

Italy has a variable climate, so different areas can experience different weather. In general, the country has four seasons: spring (March to May), summer (June to August), autumn (September to November), and winter (December to February). Summer has marvelous weather, with sunny days and warm nights. Autumn brings cooler temperatures to the country, while the winter can be chilly or freezing, depending on the area. In spring, the temperatures start to get warmer.

Getting around in Italy

Leonardo da Vinci-Fiumicino Airport is the main gateway airport in Italy. It connects the country with numerous domestic and international destinations, including London, Beijing, Paris, New York, and Moscow. Many international visitors fly to the Milan Malpensa International Airport as well. Transport in Italy is reasonably priced and efficient. An extensive network of domestic flights is available, making it the quickest and most convenient way to travel around. Trains cover many areas across the country and have frequent departures. There are also high-speed trains connecting major cities. Although buses are slower than trains, they are cheaper and covers areas not served by trains. All major cities have good transport systems, with the bus, metro, and tram networks. In Venice, the vaporetti (small passenger ferries) are the main public transport option. Taxis are widely available and are moderately priced.

Tourist Visas in Italy

Since Italy is part of the Schengen area, nationals of EU countries do not need a visa to visit regardless of their purpose and/or length of stay. Citizens of Canada, Australia, the US, Hong Kong, South Korea, the UAE, and several other countries do not need a visa to stay in the country for up to 90 days within a six-month period. Other nationals not listed in the visa exemption countries will need to apply for a visa before visiting.

Additional Information

1. Local Currency: The euro (€) is the official currency of Italy. The exchange rate from €1 is approximately US$1.17.
2. Money & Payments:  ATMs can be found easily throughout Italy, but make sure to be vigilant when making cash withdrawals in tourist areas since pickpocketing is common. Major credit cards are widely accepted. Tipping is not expected. However, you can always tip an extra 10% to 15% for exceptional service.
3. Local Language: Italian is the official and most commonly spoken language in Italy. English is not widely spoken, except in larger cities such as Rome, Milan, and Florence.
4. Local Culture and Religion: Roman Catholicism makes up around 80% of the population. The other 20% is made up of Muslims, agnostics, and atheists. 
5. Public holidays: Italy mostly celebrates Christian holidays. Some of the most important are Epiphany, Pasquetta, Saints Day, Liberation Day, and Christmas.