Neurology in Selangor

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 Selangor?

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 Selangor 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 Selangor

About Selangor

Occupying the status of both the most populous and developed state, Selangor is indeed the pride of Malaysia. Its advanced infrastructure and superior living standards, coupled with the country's lowest instance of poverty, make it stand out. Perfectly positioned on the western coast of Peninsular Malaysia, it envelops Kuala Lumpur and Putrajaya, both of which were formerly a part of Selangor. Despite its impressive development marked by towering structures,

Selangor manages to retain its natural charm boasting splendid landscapes and tranquil retreats. The state's deep-rooted cultural essence and unmatched healthcare services further enhance its appeal.

Selangor is the medical tourists’ favorite destination because of its geographical position and low cost of living. The state has some of the best medical experts with 12 government hospitals and over 30 private hospitals and medical centers, many of which are recognized internationally and accredited by Joined Commission International and the Malaysia Society for Quality in Health (MSQH).

Selangor has become a preferred destination for medical tourists who seek procedures such as dental surgeries, cosmetic surgeries, IVF treatments, and eye surgeries. Among the numerous hospitals offering these procedures, KPJ Ampang Puteri and Sunfert International Fertility Centre have gained immense popularity due to their high standards and patient-centric approach. This underlines Selangor's standing as a leading destination for healthcare in the region.

Popular Areas in Selangor

Tourists who want to indulge in Selangor’s beautiful nature can go to Kuala Selangor Beach (Mirror of the Sky), Chilling Waterfalls, Kuala Selangor Nature Park, or the National Zoo of Malaysia. Those who want to experience culture can visit Galeri Diraja Sultan Abdul Aziz, Mah Meri Cultural Village, and Sultan Alam Shah Muzeum.

Among Selangor's numerous tourist magnets, Batu Caves stands out. This impressive limestone hill is home to three large caves and multiple smaller ones. Revered as a national treasure of Malaysia, Batu Caves hold immense religious significance for the Hindu community.

Visitors are always in awe of the world's tallest statue of the Hindu deity, Murugan, situated here. In addition to the religious and natural appeal, the site also offers sights of varied cave fauna and thrilling climbing routes, delivering an all-round enriching experience.

The state’s capital, Shah Alam, also has plenty to offer. Tourists can go to I-City to see millions of LED lights, indoor park, or to shop. The Blue Mosque (Sultan Salahuddin Abdul Aziz Shah Mosque) is also a popular destination where tourists can see the beautiful mix of Islamic and Malay architecture.

Weather and Climate in Selangor

Adorned with a tropical rainforest climate, Selangor is characterized by a warm and humid environment all year round. Daytime temperatures generally fluctuate between 25 - 35°C, but during the dry season, these can peak at a scorching 37°C.

The wet season ushers into the region as the calendar transitions into April, often extending as far as October, leaving the land generously watered. An increased intensity of rains is observed towards September and October, marking the peak of the rainy spell. For prospective visitors seeking to avoid the wet season, the months from late November to February typically prove the most comfortable for exploring and sightseeing, blessed with less rainfall and mild temperatures.

However, it should be remembered that even amidst the monsoon season, the weather isn't uniformly gloomy; there are often luminous intermissions. The sun tends to break through the rain-soaked clouds, bathing the land in its warm rays. Consequently, even during the monsoons, numerous days are well-lit, and visitors have ample opportunities to explore the local beauty undeterred. Brazil, in every season, has its unique appeal. Whether it's soaked in rain or draped in warm sunshine, it never fails to mesmerize its guests.

Getting Around in Selangor

There are two main airports: Kuala Lumpur International Airport (KLIA) and Subang Airport. Kuala Lumpur International Airport is the main airport in Malaysia that has a multitude of routes across the globe. The airport is divided into two parts, KLIA that mostly serves large airlines, and KLIA 2 that focuses on serving low-cost carries. Subang Airport is the hub for FireFly and Malindo Air.

Navigating Selangor is made effortless by its well-established infrastructure. The primary means of transportation include taxis, trains, and buses. Taxis, while economical, can prove to be slightly tricky, as some drivers refrain from using the fare meter. Visitors are therefore advised to approach taxi counters to secure a fixed-rate coupon, ensuring they aren't subjected to inflated prices.

Public transit systems like the KTM Komuter Train, MRT, and LRT are widely recognized as the most efficient modes of transportation for traversing Selangor. However, it's important to note that these service networks may not extend to certain rural areas. When visiting these less accessible regions, tourists may find it beneficial to hire a car, thereby gaining the advantage of flexibility. Alternatively, the option of using bus services provides a more economical solution for easy mobility.

Tourist Visas in Selangor

Nationals hailing from countries like China, India, Myanmar, Sri Lanka, Nepal, Bangladesh, Pakistan, Bhutan, Serbia, and Montenegro are required to secure a visa prior to their arrival in Malaysia. Meanwhile, most other nationalities are offered the convenience of visa-free entry, valid for either a 30-day or 90-day stay. It is crucial for all visitors, regardless of their country of origin, to hold a passport that remains valid for at least six months subsequent to their entry into Malaysia.

An online visa application platform or eVisa is available for selected foreign nationals. eVisa can be applied around the world except for Malaysia and Singapore. Tourists who wish to visit Malaysia for medical treatment can apply for an eVisa Medical, valid for a single journey with a maximum of 30 days. The Malaysian Government has a very strict visa regulation, overstaying will result in RM10.000 fine and/or 5 year’s imprisonment, do ensure to extend your tourist visa if you need to.

Additional Information

1. Local Currency: Malaysian Ringgit is the local currency with 1USD equivalent to RM4.72. The currency is printed in various colors and sizes, making it easier and less confusing for travelers to work with the currency to avoid giving the wrong bills when shopping. The Malaysian Ringgit is formerly known as ‘Malaysian Dollar,’ older Malaysians sometimes refer to it as ‘Dollars,’ you can ask which dollar they mean if you are unsure.
2. Money & Payments: ATMs are widely available in the state. Credit cards (MasterCard and Visa) are accepted in most hotels and established restaurants. Tipping is not a common culture and many restaurants already add a service charge onto the bills, but tourists may tip.
3. Local Language: The national language is Malay, but English is in extensive use since many locals can speak English. Tamil, Mandarin, and Cantonese are also widely spoken.
4. Local Culture and Religion: Many people from different ethnicity coexist in Selangor. Malay, Chinese, and Indians are among the biggest ones. The official religion is Islam, as in other parts of Malaysia; with 57.9% percent of the population is Muslim, followed by Buddhist, Hindu, Christian, and Taoism.
5. Public Holiday: The rich racial diversity in Selangor is greatly celebrated all year round, especially on the holy days of every religion such as Aidilfitri, Chinese New Year, Thaipusam, and Deepavali. Selangor also hosts the three-day Thaipusam festival around January or early February, when hundreds of thousands of pilgrims meet at Batu Caves.