Neurology in Penang

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 Penang?

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 Penang 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 Penang

About Penang

Penang is one of the most visited states in Malaysia and is located on the north-west coast of Peninsular Malaysia. Penang consist of two parts: Penang Island and Seberang Perai. Widely known as the ‘Pearl of the Orient,’ Penang attracts millions of tourists every year with its mixture of multicultural heritage, natural charms, and wonderful food.

Penang is also a popular medical tourism destination, with around 60% of the tourists who visited the state in 2017 came for affordable, high-quality medical treatment. According to the former Chief Minister of Penang, Lim Guan Eng, Penang’s medical tourism contributed 42.3% in revenue to the health tourism market in Malaysia. Medical tourists get the best in terms of quality, options, and savings. The top medical procedures are cosmetic surgery, eye care, and dental surgery.

Penang is a preferred medical tourism destination for the following reason:

• World-class doctors and well-trained nurses.
• Offers a wide range of excellent healthcare services.
• Affordable medical procedures cost less than other medical countries.
• No queue for specialist consultations.
• Public and private hospitals with global accreditation to ensure quality care.
• The perfect environment for rejuvenation and recovery.

Popular Areas in Penang

Packed with diverse culture and beautiful scenery, Penang is a wonderful place for tourists to explore. There are plenty of places to enjoy the most incredible sites including the white sand of Batu Feringghi, the iconic architecture of Kho Kongsi, the beautiful landscape from the summit of Penang Hill, the Tropical Spice Garden, and the pit vipers in the altars of Snake Temple.

Penang’s capital, George Town, is listed as a UNESCO World Heritage Site. George Town is home to a great number of heritage and arts as well as the largest collection of pre-war buildings in Southeast Asia. This historical city is the best place for tourists who want to indulge in cultural sight.

Considered as one of the best places in the world to savor delicious food, the culinary in Penang is a blend of Malay, Chinese, Indian, Peranakan, Thai, and European specialties. Tourists can try traditional cuisines such as Assam Laksa, Nasi Lemak, Lok Lok, and many more. Vegetarian versions of the famous local street dishes are also available in various Chinese and Indian outlets.

Weather and Climate in Penang

Just like any other parts of Malaysia, Penang enjoys a year-round tropical rainforest climate which means it is warm and humid throughout the year. However, the temperature of Penang Island is often higher than the mainland. The average temperatures range between 29–32°C during the day and 25–29°C during the night.

The weather is usually warm in January and February. The rainy season usually starts during the southwest monsoon from April to September and October to early November. The best time to visit Penang is from late November to February as the weather is mostly sunny but it’s not too hot or humid to do outdoor activities during the day.

Getting Around in Penang

Penang is easily accessible by air since Penang International Airport has daily flights to and from domestic destinations and has International connections with Singapore, Jakarta, Bangkok, Taipei, Hanoi, and many more major cities in Asia. The airport mainly serves budget airlines such as AirAsia and Firefly, although larger airlines including MAS and Qatar Airways also operate less frequent flights.

To reach George Town, tourists can take a taxi, bus, an airport transfer, or hire a car. Note that airport taxis operate on a voucher system, tourists must buy a voucher beforehand from inside the terminal to avoid taxi cheats. The taxi fare to George Town should cost around RM38 (around 9.00 USD).

There are several different types of public transportation available in Penang. Walking or a trishaw ride is the best way to get around George Town. Free CAT Bus (Central Area Transit) is available for tourists to get to popular attractions in the capital city for free. To travel around surrounding suburban areas of George Town, tourists can opt for Grab (e-hailing apps like Uber).

For longer distance trips away from the capital city, Rapid Penang Bus, or renting a car/scooter are the best options. Taxis are widely available around the island but be sure to agree on a price first because taxis here do not use meters.

Tourist Visas in Penang

Nationals of most countries are granted visa-free entry to Malaysia for 30 or 90 days. Holders of passports issued by China, India, Sri Lanka, Nepal, Myanmar, Bangladesh, Pakistan, Bhutan, Serbia, and Montenegro are required to apply for a Malaysian tourist visa. The foreign nationals who require a visa to enter Malaysia must apply and obtain a visa in advance before entering the country.

All visitors must hold a passport valid for at least six months beyond the date of entry into Malaysia. Do ensure to have a valid visa and obey all the rules because the Malaysian Government has a very strict visa regulation and will punish those who violate the terms.

Additional Information

1. Local Currency: Malaysian Ringgit (RM) is the local currency. It is made up of 100 Sen (cent). 1USD is equivalent to RM4.20. Formerly known as the Malaysian Dollar, older Malaysians sometimes refer to Ringgit as ‘Dollars.’
2. Money & Payments: ATMs are available across Penang. Credit cards (Visa and MasterCard) are accepted in most hotels and established restaurants. There are plenty of moneychangers in the region and most banks will exchange cash with a commission. Be sure to carry small bills since many street vendors only accept cash. Tipping is not necessary because service charges are already included in hotels and restaurants but tourists may tip as a gesture of appreciation.
3. Local Language: the official language is Malay but English is widely-spoken since many locals can speak English proficiently. Other major languages spoken in Penang are Hokkien (Penang Hokkien), Teochew, Cantonese, Hakka, Mandarin, and Tamil.
4. Local Culture and Religion: Islam is the official religion of Penang but there are other religions including Buddhism, Hinduism, Taoism, and Christianity. Tourists can see the diverse culture and faith of Penang in Pitt Street, known as ‘Street of Harmony,’ where four different major places of worship stand only meters away from each other.
5. Public Holidays: Penang celebrates all the major religious holidays such as Hari Raya Aidilfitri, Chinese New Year, Wesak Day, Deepavali, and Christmas. Many festivals are lined up throughout the year. Penang also hosts unique festivals like George Town World Heritage Day every year on July 7 to commemorate the inscription of the city as a World Heritage City by UNESCO.