Neurology in Johor

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 Johor?

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 Johor 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 Johor

About Johor

Johor, the Southern Gateway to Malaysia, continues to prosper as a tourism destination. Johor’s geographical position draws many tourists from neighboring countries especially Singapore. Tourists flocked to Johor to experience its great shopping deals, cheap food, beautiful nature, and theme parks. Johor Premium Outlets, LEGOLAND Malaysia, and Sanrio Hello Kitty Town are the first of its kind in Southeast Asia. Johor is expecting a total of 17 million visitors in 2019.

Recently, Johor has become a thriving medical tourist destination. Johor recorded 60,000 medical tourists visiting the state in 2017 to seek medical treatments. As one of the biggest contributors to Malaysia’s rising medical tourism, the state keeps innovating and improving its health facilities to increase the number of medical tourists. Johor hospitals offer cutting edge technology with experienced doctors and at a reasonable price.

The hospitals in Johor are of world-class standards and accredited by global accreditation. One of the highest-rated hospitals in the state is Gleneagles Medini Hospital that offers a wide range of treatments. Cosmetic surgeries such as eyelid surgery and breast augmentation are the most popular procedures in Johor.

Popular Areas in Johor

Johor offers plenty of attractions to discover. It is easy to see why many people are drawn to travel to the state. Tourists have many options to choose the kind of adventure they want to experience, from exploring incredible islands and tropical rainforests, admiring famous historical landmarks, spending a day in theme parks, to shopping in a cosmopolitan city of Johor Bahru.

• Seribuat Archipelago lies on the east coast of Johor; the archipelago has beautiful clear waters and sandy beaches that will take your breath away. Tourists who want to discover the amazing underwater life can do many activities such as diving and snorkeling.
• Gunung Ledang National Park (Mount Ophir), the highest mountain of Johor is known as the home of a mythical princess, Puteri Gunung Ledang. Tourists can go hiking on this beautiful mountain and will be rewarded with an amazing view and do not miss out on the chance to cool off in Puteri falls.
• Legoland is the best place for tourists who travel with kids. The first Legoland in Asia offers over 70 rides with a separate water park and ‘Sea Life.’ There is also a Legoland hotel for tourists who want to fully experience the theme park.
• Sultan Abu Bakar Mosque, Johor’s state mosque, is located on top of a hill in Johor Bahru with beautiful views to the Johor Strait and Singapore. The architecture follows the style of Victorian and Moorish and takes the form of British 19th-century clock towers.

Weather and Climate in Johor

The tropical weather allows Johor to enjoy a relatively stable warm temperature throughout the year. The highest average temperature is 33°C and the lowest is 31°C. Humidity is generally high in Johor so tourists are advised to pack light and comfortable clothing.

The rainy season usually starts from April to September and from October to early November. Some islands in Seribuat Archipelago may be ‘closed’ during the rainy season due to the rough weather.

Getting Around in Johor

Senai International Airport is the gateway to Johor. Located 32km from Johor Bahru, the airport serves domestic flights as well as international flights to and from Bangkok, Jakarta, Seoul, Guangzhou, and Ho Chi Minh City. Senai International airport serves budget airlines and is the hub for AirAsia and Malindo Air.

To reach the city center, tourists can take a taxi or Airport Shuttle Bus. A ride to Johor Bahru by taxi takes approximately 30 minutes while taking the bus will take longer. Remember that taxis use a coupon system, the coupon can be bought from the taxi counter inside the Aeromall.

Tourists from Singapore can go to Johor by bus or car via Johor–Singapore Causeway. Tourist who wants to avoid traffic jams can opt for the KTM’s Shuttle Tebrau from Woodlands Train Checkpoint to Johor Bahru.

Tourists visiting Johor Bahru can travel to different attractions within the city by using the bus service although it can get pretty confusing since the bus stops may not be shown clearly. It is advisable to directly ask the bus driver for the destination. Taxis are available in the state but it is best to insist on using the meter or negotiate the fare in advance.

To travel to other cities in Johor, tourist can ride long distant buses from Larkin Bus Terminal. Buses normally leave once every hour and have a reasonable price. If you wish to travel to many cities in Johor, renting a car is the best choice.

Tourists Visas in Johor

Tourists are only allowed to enter Malaysia if their passport is valid for at least six months after arrival. Most nationalities can enter Malaysia without a visa for 30 or 90 days. Several foreign nationalities including China, India, Myanmar, Sri Lanka, Nepal Bangladesh, Pakistan, Bhutan, Serbia, and Montenegro must apply and obtain a visa before entering the country.

The Malaysian Immigration provides an online visa application for selected foreign nationals, the process is usually faster and easier. Those who travel to Johor for medical treatment can apply for eVisa Medical. The visa is valid for a single journey with a maximum of 30 days. Patients who need to stay for more than 30 days must obtain a long term Medical Pass.

Additional Information

1. Local Currency: The ringgit (RM) is the local currency. 1USD is equivalent to RM4.20. Printed in a variation of colors and sizes, it is easier and less confusing for travelers to work with the currency to avoid giving the wrong bills when shopping.
2. Money & Payments: ATMs are easily available around the state and credit cards are accepted in most hotels and restaurants. It is wise to always carry a small amount of cash especially when traveling to a more suburban area because many vendors will only accept cash, some vendors won’t change bills over RM20. Tourists can bargain with street vendors but always remember to be polite. Tipping will be appreciated but not necessary.
3. Local Language: Malay or Bahasa Melayu is the official language in Johor. The majority of people, especially in Johor Bahru, can speak English relatively well. Directions and signs are usually written in Malay and English. Other languages that are widely-spoken in Johor are Mandarin Chinese and Tamil.
4. Local Culture and Religion: The state’s culture is heavily influenced by the Arabs, Javanese, and Bugis people. Johor is also home to a large Chinese and Indian community. The official religion is Islam with Buddhism, Hinduism, Christianity, as the other religions freely practiced.
5. Public Holidays: It is important to keep in mind that the weekend in Johor is Friday and Saturday. Like other parts of Malaysia, Johor celebrates the holy days of every major religion and holds a number of festivals throughout the year. One of the most famous festivals in Johor is the annual Pasir Gudang World Kite Festival. Usually held around February and March, the festival showcases one thousand modern and traditional kites.