Neurology in New York City

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 New York City?

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 New York City 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 New York City

About New York

New York City, or simply New York (NY), is the most populous city in the United States with an estimated population of over 8 million. The city is labeled as the cultural, financial, and media capital of the world. It is an important center of international diplomacy since it houses the headquarters of the United Nations. The city has been attracting tourists from all around the globe for its architectural beauty, dining spots, and arts. Fueled by its global popularity and superior healthcare, the city also welcomes patients from many other countries to undergo cosmetic surgeries and complex or rare procedures that are not available in the patient’s home country. The medical professionals are highly qualified, skilled, and experienced. The medical costs might not be the cheapest, but patients will get the best treatment in the world.

Popular Areas in New York

New York offers its visitors a myriad of attractions to see and things to do. Tourists can find world-famous sites in almost every corner. The following are the most popular places in the city.

• Statue of Liberty is a symbol of freedom and democracy. It was a gift from the French people to the people of the United States as a monument of international friendship during the American Revolution. This famous statue was designed by French sculptor Frédéric Auguste Bartholdi, and the metal framework was built by Gustave Eiffel. Tourists can access the pedestal and the crown. Although the climb to the top is strenuous, the view from Lady Liberty’s crown is breathtaking, making it one of the most rewarding experiences of your trip to NYC. To get to the statue, you need to take a ferry from Battery Park City or New Jersey. There is only one official ferry company that is allowed to take you to the islands, Statue Cruises.
• Staten Island Ferry offers a stunning landscape of New York City and the Statue of Liberty. The ferry runs frequently and is free. Tourists can enjoy the refreshing breeze while admiring Governors Island, the Brooklyn Bridge, lower Manhattan and Wall Street’s skyscrapers, Ellis Island, the Statue of Liberty, and the Verrazano-Narrows Bridge.
• Empire State Building is perhaps the most iconic symbol of New York City. This magnificent landmark should not be missed by any visitors. The building was opened during the Great Depression in 1931 and tourists can see its Art Deco style in the architecture. The view from its 86th and 102nd floors is spectacular, especially around sunset time. 
• Central Park is 843 acres of open space and is a good place to escape from the concrete jungle of New York City. The park was designed by Frederick Law Olmsted and Calvert Vaux, and it was the first major landscaped public park in the United States. Tourists can wander around the park, enjoy a picnic, visit a memorial to John Lennon, or interact with animals in the Zoo.

Weather and Climate in New York

New York City has four seasons, each with its own perks, which makes the city a year-round destination.

• Spring starts in March and ends in April. The city enjoys a pleasant temperature during this season. It is one of the most beautiful times to visit since the city is filled with Cherry Blossoms and hosts a number of festivals. However, expect to experience seasonal storms.
• Summer is from June to August. The temperatures are mostly warm, with an average between 25 °C to 30 °C. The city is usually crowded and busy during this season, but tourists can enjoy several free summer concerts. 
• Autumn is a great time to visit New York City, which lasts from September to November. The summer heat will be replaced with a cooler temperature, and the city is overflowing with red and orange leaves. 
• Winter in the city can be freezing and sometimes snowy. The season starts in December and ends in February. The temperatures can drop as low as -25 °C. If you plan to visit during winter, make sure to dress properly.

Getting Around in New York

The primary international airport in New York City is the John F. Kennedy International Airport. More than ninety airlines operate from this airport, including several budget airlines such as JetBlue. Getting around the city is fairly easy and inexpensive, especially by public transportation. The city has 27 subway lines stopping at 472 stations and more than 5,000 buses. To ride the subway, you will need to purchase a MetroCard that cost $1. The fares are $2.75 per trip and you can buy a one week unlimited MetroCard for $33 or an unlimited monthly MetroCard for $127.

The bus will take you to many places including the east or west portions of Manhattan. The bus fares are $2.75 per trip and the buses only accept MetroCard or exact fare in coins. If you do not want the hassle to figure out the public transportation system, the iconic yellow taxis are widely available. You can flag them down directly from the streets. The taxis are green in Brooklyn and Uber and Lyft are also available. 

Tourists Visas in New York

Citizens of Canada, Marshall Islands, Micronesia, Palau, and Bermuda are given visa exemption access. Holders of passports issued by 38 countries including Australia, Singapore, and the United Kingdom are selected for the Visa Waiver Program. Nationals from countries that are not listed in the visa exemption and visa waiver program need to apply for a visa. All visitors may stay for a maximum of 90 days. It is advisable to learn more about the visa policy at your nearest United States Embassy.  

Additional Information

1. Local Currency: US dollar ($) is the official currency. Please check XE.com for the current exchange rate to your local currency.
2. Money & Payments: ATMs can be found everywhere, and credit cards are accepted at most hotels, restaurants, and shops. Tipping is not optional. For restaurant servers and bartenders, 15% - 20% of the bill is acceptable.
3. Local Language: The main language in New York City is English. However, there are over 800 languages spoken in the city, such as Spanish and Chinese.
4. Local Culture and Religion: Christianity is the major religion in New York City, followed by Judaism, Islam, Buddha, and Hindu. 
5. Public Holidays: New York City celebrates various holidays, including New Year, Martin Luther King Jr Day, Independence Day, Thanksgiving Day, and Christmas Day.