Neurology in Philippines

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 Philippines?

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 Philippines 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 Philippines

About the Philippines

The Philippines is an island nation in the heart of Southeast Asia. It extends from the south of China to the northern tip of Borneo. It is also known as the ‘Pearl of the Orient Seas’, the Philippines is an archipelago of 7,107 islands. It comprises three main island groups, Luzon, Visayas, and Mindanao. Manila, the capital city, lies in the southwestern part of Luzon. Quezon City is the largest and most populous city in the country.

It is a prominent English-speaking country and was once a colony of Spain and the United States. It’s the most Westernised country in Asia. However, its culture is a mix of indigenous Malay culture and Spanish and American heritage.

Besides being one of the top tourist destinations, the Philippines is also an emerging medical tourism destination. It ranks in 8th position among popular medical tourism countries and more than 10,000 medical tourists visit the Philippines every year for various treatments. The following factors all contribute to the progress of medical tourism within the Philippines.

• Expert and board-certified medical professionals with international qualifications and training.
• Internationally-accredited hospitals with state-of-the-art medical equipment and modern facilities.
• Affordable costs compared to advanced nations
• Inexpensive accommodation
• The English language is widely-spoken making communication with the Medical team and patients easy.
• Tropical climate helps in the recovery and recuperation

The most common and popular procedures and treatments in the Philippines are cosmetic surgery, weight-loss surgery, dermatology, ophthalmology, and dentistry. As of late, people come here even for liver and kidney transplant surgeries, and cardiac surgeries due to the cost advantage it provides.

For example, a Breast Augmentation surgery that costs between $7,500-$8,500 in the US costs only between $3,000-$3,500 in the Philippines which would be a saving of about 58% to 60%. Also, a coronary artery bypass surgery costing $70,000-$133,000 in the US, will only cost between $11,500-$17,500 and would result in a saving of almost 83% to 86%. Even after adding travel and living expenses, it still makes it a, very good value for the patient to get medical care in the Philippines and several of the more popular Hospital and Clinics are located in Manila, and are St. Luke's Medical Center, Makati Medical Center, The Medical City and Asian Hospital and Medical Center

Popular Parts of the Philippines

The Philippines has a total land area of 116,000 square miles, with a large population of 107,791,044 million people. It has many pristine beaches, mountains, rainforests, islands, heritage towns, and monuments, With hotels, food, and transportation very affordable, it’s also a good budget tourism destination.

The following are some of the most beautiful places to visit in the Philippines:

• El Nido –is known for its white-sand beaches, clear turquoise waters, and coral reefs and is the gateway to the Bacuit archipelago which is a group of islands. The laid-back town of El Nido is a base for island-hopping tours, and kayaking trips to mountainous Cadlao Island, El Nido is situated on the northern edge of mainland Palawan.
• Coron – Is also situated in Palawan and is known for its warm waters, ideal for snorkeling, kayaking, and deep diving. The breathtaking Kayangan Lake, surrounded by karst walls is a visual treat. It is the cleanest lake in the Philippines.
• Tubbataha Reefs Natural Park –is also part of Palawan and is situated to the southeast, in the Sulu Sea. It’s home to countless coral reefs, and expansive breeds of fish, dolphins, sharks, and whales and It is a great water destination for divers.
• Banaue Rice Terraces – They lie within the mountainous region of the Cordilleras. The rice terraces are about 2,000 years old, a result of the labor of the predecessors of the region and They provide efficient space for people to farm on.
• Intramuros – The walled historical area of Manila contains the remains of a bygone era with its cobblestone streets and preserved remnants. Walking tours and carromata rides (two-wheeled box-like vehicles drawn by a single native pony) are popular here.
• Mount Mayon –is a 2,500-meter-tall active volcano. It’s famed for its perfect symmetry and accurate conical shape. You can enjoy the view from some distance or experience it at close quarters, by hiking for a couple of days.
• Hinatuan Enchanted River – Locals believe the river has mystical qualities. They feel fairies and Engkanto (other nature spirits) guard the enchanting blue-green river. The unknown source of clear saltwater is another mystery surrounding the river.

Boracay and Siargao are other popular tourist spots with their powdery white sand and water activities.

Weather and Climate in the Philippines

The Philippines has a tropical maritime climate. The general weather is hot and very humid. It experiences only three seasons:

1. Summer Season – A very hot and dry summer season is between March and May.
2. Wet Season – Rainy Season is between June and November when the southwest monsoon is most active. In this period, typhoons are common, especially during September and October.
3. Dry Season – There is a cool and dry season between December and February, due to the cold winds brought in by the northeastern monsoon.

The average temperature of the Philippines ranges between 25°C and 32°C (78-90°F) with humidity of about 77%. High-altitude areas are much cooler, with night temperatures dropping to 20°C (68°F). The average annual temperature is around 26.6°C (79.9°F)

Getting Around in the Philippines

The Philippines is an island nation, most international travelers reach the country by air. The country has many international airports in various cities including Cebu, Davao, Manila, Kalibo, and Angeles.

Many airlines operate flights in and out of Manila to several destinations. Philippine Airlines, Cebu Pacific, and Air Asia are the national carriers of the Philippines. Singapore Airlines, Cathay Pacific, and many Middle Eastern airlines operate direct flights to Manila. The Southeast Asian cities of Bangkok and Ho Chi Minh City have wide connectivity to Manila and Cebu. You can reach Manila directly from London by flying Philippine Airlines. US travelers can fly via Japan to the Philippines.

Cebu Pacific, Tigerair Philippines, and PAL Express are some low-cost carriers that service domestic destinations in the country.

For transport within the Philippines, you have Jeepneys which are WWII- army jeeps converted into transport jeeps. They are cheap, open, and usually fully loaded with passengers which are normally cramped with 14 to 20 people sitting shoulder to shoulder depending on the length of the vehicle They operate as collective taxis, picking up and dropping passengers within cities.

Tourist Visas in the Philippines

Travelers from more than 150 countries that have diplomatic relations with the Philippines can enter the country without a tourist visa. EU, Australia, Japan, and the US are a few visa-exempt countries. In general, you can stay for up to 30 days, provided your passport is valid for at least six months after your arrival. Showing proof of onward and return journeys is compulsory.

Citizens of India, China, and Egypt are some of the countries that will need to get a visa in advance to enter the Philippines.

Additional Information

• Philippine Peso or Piso (PHP) is the official currency of the Philippines. Its subdivision is 100 centavos or centimos for a Peso. The current exchange rate for one US dollar is 51.99 PHP. You will be able to use US Dollars in Metro Manila and possibly in Cebu City. In other areas, it’s better to have pesos for exchange.
• You will find all major banks and plenty of ATMs everywhere. Master and Visa cards are accepted in most businesses.
• Tagalog or Filipino language is the main spoken language. English is also spoken and understood in the Philippines, due to the US influence during its colonization.
• Roman Catholicism is the major religion of the Philippines. 91% of the population are Christians and about 5.5% comprises of Islam religion.
• New Year’s Day, Araw ng Kagitingan, Independence Day, National Hero’s Day, Bonifacio Day, and Christmas are some of the important holidays in the Philippines.