Neurology in Malaysia

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 Malaysia?

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 Malaysia 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 Malaysia

About Malaysia

Malaysia is a rich culturally-oriented tourist destination and has a beautiful blend of modernization with a relaxed lifestyle. The population of the country is 32 Million people and Malaysia’s economy ranks in the fourth position in terms of size in Southeast Asia, The electronics, automotive, and construction industries are the biggest industries in Malaysia. The capital is Kuala Lumpur and It is the country’s largest urban area and is the cultural, commercial, and transportation center.

Presently, Malaysia stands as a renowned destination for its exemplary healthcare facilities, offering these high-quality services at notably affordable costs when juxtaposed against other globally recognized medical nations. As per predictions from the Ministry of Finance, the influx of medical tourists is expected to surge beyond 2,000,000 million by 2020. This forecasted growth can be largely attributed to the exemption of taxes imposed on medical bills.

The cities that top the list of medical travel include Kuala Lumpur, Penang, Selangor, Sarawak, and Melaka. Statistics reveal that among the 1.2 million patients who have visited Malaysia for medical care in 2017, 600,000 alone were from Indonesia. The most-sought-after medical procedures are cosmetic surgery, Brazilian butt-lift, and dental surgery. Malaysia is a favorite destination among medical tourists globally for the following reasons.

• The Country possesses a plethora of world-class hospitals that have high-tech medical equipment.
• All treatment plans match very high ethical medical standards.
• The doctors and paramedical staff are well-qualified.
• All procedures will cost you 50% less than other well known medical countries.
• English is a major language and there is good two-way communication between the doctors/medical staff and the patients.
• After an elective surgical operation, many patients will stay on in Malaysia to holiday and recuperate.

Some of the top-rated five-star medical tourism hospitals within the country include Columbia Asia Extended Care Hospital situated in Selangor, Sunway Velocity Medical Centre located in Kuala Lumpur, and Sunway Medical Centre based in Selangor.

Popular parts of Malaysia

Undoubtedly, Malaysia's appeal is immediately evident. The variety of experiences it offers, from bustling cities to idyllic landscapes, entrances visitors. Malaysia's multiculturalism, expressed through unique customs and diverse cuisines, only enhances its charm. This draws tourists from all corners of the globe, leaving them yearning for more. Succinctly, the splendor and diversity of Malaysia make it hard to resist repeated visits.

• Kuala Lumpur has a  mix of Malay, Indian, and Chinese influence which gives you a great selection of culinary delights to explore in this city. Interesting sights such as the Petronas Towers which is one of the tallest twin towers in the world. the Perdana Lake Gardens and the Menara KL Tower provide plenty of enjoyable distractions.
• Penang is an island on the west coast and the colonial city of Georgetown was made a UNESCO World Heritage Site and you can enjoy the museums, seaside fort, historic buildings. Penang is considered one of the best places in Southeast Asia to sample delicious street food of all types.

The must-visit cities in Malaysia renowned for their world-class appeal include Malacca, Langkawi, Kuching, Spaden, Johor Bahru, and Taiping.

Weather and Climate in Malaysia

Malaysia is a place that's warm all year round, as being in the tropical region. But since it's close to the ocean, the air can get pretty moist. Still, it's re-assuring to note that it doesn't get too hot, with temperatures usually staying between a pleasant 20°C and 30°C all throughout the year. Those who prefer cooler weather can visit the highlands in Malaysia, where it's generally chillier.

When planning a trip it's important to take into account the best times to visit different parts of the country. If you're eyeing the east coast, try to schedule your visit between March and September; this period is relatively drier than other months. On the other hand, the west coast is better visited from November to August. It's best to avoid the heavy rains which usually occur from September to October. With this information, you can plan to get the best out of your trip to Malaysia.

Getting around in Malaysia

The Country has a well-developed transport network and efficient rail links which makes all travel around the country easy.

It is advisable to book domestic transport well in advance during the main festivals, such as Chinese New Year, Hari Raya Pusa and Hari Raya Haji. Domestic flights and domestic express bus services are often sold out weeks before these festivals. All the major cities in Malaysia have an airport and most budget airlines operate into the country.

In the larger cities of Malaysia, you'll find that transportation is convenient with many kinds of vehicles to choose from. Specifically in Kuala Lumpur, the capital city, there's a broad range of public transportation options to get around. You can hop on buses for an affordable ride or opt for minibusses, locally known as "bas-mini" to navigate through narrower streets.

Furthermore, taxis are easily accessible in Kuala Lumpur, providing a convenient alternative when you prefer more comfort or need to reach a specific destination quickly. If you would like to experience something traditional and fun, pedicabs or "trishaws" as they are commonly known, are present in some parts of the city offering you a unique ride.

Additionally, Kuala Lumpur also boasts a well-connected train network, including rapid transit and commuter rail services, facilitating quick and efficient travel across the city. It's safe to say that in Kuala Lumpur, moving around is smooth and easy, thanks to these diverse means of transportation.

In Malaysian towns and cities, various modes of transport are used, including ferry services. In cities, the rail network is a good way to get around, especially the KL Monorail and transit trains.

Tourist Visas in Malaysia

The residents of the following countries holding a valid passport are the ones required to apply for a Malaysian tourist visa. China, India, Sri Lanka, Nepal, Myanmar, Bangladesh, Pakistan, Bhutan, Serbia, and Montenegro

All other nationalities will not need a visa to visit Malaysia. You will normally be given permission to stay for 3 months on arrival. Visas for longer stays or for non-tourist purposes must be obtained from the nearest Malaysian diplomatic mission before you travel.

The Malaysian authorities are running a vigorous campaign against illegal immigration. Don’t overstay your visa, or violate the terms of entry. Even if you overstay for just a few days, you can be fined, detained, deported, and blacklisted. Flight costs will be the responsibility of the individual.

Additional Information

• Local currency: Ringgit, denoted as RM, is the national Malaysian Currency. Printed in various colors, size, and physical appearance, the Bank Negara Malaysia and the National Bank of Malaysia control the issuing of currency. Malaysia follows the Chinese Model where it has cut itself away from comparing it to US dollars. The Malaysian currency is as such not traded internationally.
• Money and Payments: world-class restaurants and retail stores accept all forms of Credit cards. In case you are not holding the requisite quantity of local currency with you, you can exchange them at exchange bureaus. You can even take out cash from the ATMs.
• Local language: The official language is Malay and English is also widely spoken, the state has a cosmopolitan population, languages such as Arabic, Hindi, Tamil, are also spoken.
• Public holidays: The local population celebrates the Gregorian New year as well as the Chinese New Year. Since a large part of the population is Indian, Malaysia also celebrates some of the traditional Indian festivals such as Pongal, Diwali, and Tamil New Year.