Neurology in Johannesburg

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 Johannesburg?

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 Johannesburg 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 Johannesburg

About Johannesburg

Johannesburg is the most populous as well as the largest city in South Africa. There is a lot to see and do in Johannesburg. Home to the Apartheid Museum, it is the perfect place for anyone who loves history and wants to learn more about the country’s past. There are also MOAD and MuseuMAfriCA that exhibit the city’s art and history. Other than the museums, the metropolitan city has a number of other things to do, such as enjoying Gold Reef City, shopping in its many markets, and visiting The Cradle of Human Kind.

Today, people have found a new reason to visit Johannesburg: medical tourism. Although it is not as widely known as other medical tourism destinations in other parts of the world, the city has seen a steady rise in medical tourists. The urban city features public and private medical centers with the highest standards, well-trained medical practitioners, and cutting-edge technology. Most of the medical centers have English speaking doctors, nurses, and staff, so there is no language barrier for foreign medical tourists. Plastic surgery, particularly tummy tuck, is one of the more popular procedures since it is much cheaper here than in Western countries.

Popular Areas in Johannesburg

While Johannesburg is not a popular tourist destination, there are a number of things to see and do in the city. The city is mostly known as Nelson Mandela’s home and has an array of astonishing museums. Those who love history and want to learn about the country’s struggle will enjoy the Apartheid Museum. It exhibits the story of apartheid through photographs, film footage, clippings, newspaper, and artifacts. Mandela House in Soweto Street is also worth a visit. It was once Nelson Mandela’s home. The museum showcases photographs, paintings, as well as awards and recognitions earned by Nelson Mandela. 

One of the most popular places is the Lion Park. The safari park offers an amazing chance to watch lions and several other animals up close. There are also other activities such as animal interactions and hand-feeding a few animals, such as ostriches and giraffes. Other than the Lion Park, Pilanesberg National Park is famous among wildlife enthusiast. The national park is filled with opulent ecosystem and wildlife. Tourists can experience a safari and spot lions, rhinos, elephants, leopards, zebras, and over 300 bird species in their natural habitat. 

Johannesburg is popular for its art and you must visit the Maboneng Precinct where you will find art-studios and shops selling art pieces. Wits Art Museum is another great place to admire African art. If you want to know more about the culture, Lesedi Cultural Village is the best place to go. Here, tourists can learn more about traditional South African culture and a chance to encounter people of Zulu, Pedi, Ndebele, Xhosa, and Basotho origin. Other places including SAB World of Beer, Gold Reef City, Holly Hill, Market Theatre, Constitution Hill, and Mary Fitzgerald Square are also a must-visit. 

Weather and Climate in Johannesburg

Johannesburg experiences a subtropical highland climate. The summer, which runs from October to April, is characterized by hot days with thundershowers in the afternoon and cool evenings. The temperature is mostly mild during the summer. January is one of the hottest months, with an average maximum daytime temperature of 25.6 °C. The summer has an extreme UV index, sometimes reaching as high as 14-16. Therefore, tourists must wear sun-protective clothing and apply sunscreen during the day to avoid sunburn.

In the winter, the city enjoys sunny days and cold nights. This season is dry, and the average maximum temperature is around 16 °C. In June and July, the temperature can drop to 4.1 °C and occasionally drops below freezing at night. The freezing temperature causes frost, but snow is rare. It is advisable to bring warm clothing during this season.

Getting Around in Johannesburg

International visitors usually arrive at O. R. Tambo International Airport, also known as Johannesburg International Airport. It is Africa’s busiest airport and the primary airport that serves domestic and international travel. The airport connects South Africa with various cities all over the world, including London, Abu Dhabi, Atlanta, Singapore, and Sydney. It is the hub for South Africa’s largest domestic and international airlines, South African Airways. Budget airlines such as FlySafair, Mango, and Kalula operate flights from this airport for an inexpensive travel option. 

Johannesburg has a vast public transport system. The Gautrain rapid-rail is safe and fairly easy to navigate. The rail also links the city center with O. R. Tambo International Airport. For efficient transport, tourists can opt for the Rea Vaya bus service that has a circular route through the city and is useful to explore the City Center at a reasonable cost. Many locals will use the minibus taxi network, but it can be pretty confusing for foreign tourists. Passengers need to know a route to their destination, hail the minibus taxi from the street, and once they have arrived at their desired destination, they need to make a hand signal to stop the minibus. 

Metered taxis are available but can be quite expensive. The taxis are mostly found outside hotels. Since there are only a few places to hail a taxi in the street, the best way to hail a taxi is by phone. Be careful because many taxis do not use meters so tourists would need to negotiate the price before getting in. The most reliable metered taxis are Orange Cabs, Quick Cab, and Zebra Cabs. Uber is also available for safer, quicker, and more affordable transport.

Tourist Visas in Johannesburg

All visitors who wish to enter South Africa must hold a passport valid for at least 30 days after the expiration of their intended visit and must have at least two unused pages. Passport holders of more than 60 countries can enter and stay for up to 90 days in the country without a visa. Other nationals not listed in the visa exemption agreement must obtain a visa to the nearest South Africa embassy or consulate. The South Africa Immigration Department also offers Medical Treatment Visa for medical tourists.

Additional Information

1. Local Currency: The local currency is the South African Rand (ZAR). 1 USD is equivalent to 14 ZAR.
2. Money & Payments: ATMs are available at every commercial center. Most hotels, restaurants, and shops accept credit cards (especially MasterCard and Visa). However, be sure to always carry some cash since there are several cases of credit card fraud. Tourists must tip car guards, but should not tip minibus taxi drivers. For bars and restaurants, 10% to 20% of the bill is acceptable.
3. Local Language: Most people will speak more than two languages, including Nguni, Sotho, English, Afrikaans, and Tshivenda.
4. Local Culture and Religion: More than 50% of the population follows Christianity and more than 20% are not affiliated with any religion. There are small groups of Muslim, Jewish, and Hindus. 
5. Public Holidays: There are around 12 official public holidays in the city such as Good Friday, Freedom Day, Heritage Day, and Christmas Day.