Neurology in Singapore

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 Singapore?

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 Singapore 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 Singapore

About Singapore

Singapore is a small, yet beautiful island city-state in South East Asia. The country's growth and prosperity in terms of infrastructure and economy are astounding and Singapore is affluent and tax-friendly and its GDP is on par with developed European nations.

Singapore is a global center for education, technology, tourism, trade, logistics, and healthcare. Medical expenses in Singapore are expensive when compared to Thailand and India. Yet, the country attracts medical tourists with its cleanliness, world-class medical infrastructure, and facilities. A C-section will cost anywhere between $6,048 and $11,267 in Singapore. Hip replacements can cost around $8,550-$12,850 and breast lump removal will cost you $5,459-$10,700 including a private room.

The country has 15 JCI accredited hospitals and medical centers, which offer a variety of services from orthopedics, dermatology, dental, cardiology, ophthalmology, and cosmetic procedures to alternative therapies such as acupuncture and Ayurveda. English-speaking medical professionals are extremely skilled and experienced. The hospitals in Singapore have access to cutting edge technologies and it is the best country to treat life-threatening, complex conditions.

It is advisable for medical tourists to have an International Health Insurance Plan to cover surgical costs. Most of the reputed hospitals in Singapore will only admit foreign patients with health insurance.

Medical care in Singapore is not just about getting preventive care and treatments for medical conditions that one may have. Some of the health care centers in Singapore are super luxurious and you can even order your food and shop using wireless tablets provided and make use of the nearby spas. Popular Hospitals and Clinics are the Farrer Park Hospital, Gleneagles Hospital Singapore, Mount Elizabeth Hospital, Parkway East Hospital, and Thomson Medical Centre.

Popular parts of Singapore

Singapore is home to over 5.5 million people and its cultural diversity is displayed in the extensive ethnic cuisine and major festivals. Singapore ranks number ten in the world for skyscrapers.

• Sentosa: Each of Sentosa’s three beaches: Siloso, Palawan, and Tanjong—hold their own unique charms. Palawan beach’s islets and playgrounds are great spaces for families to unwind. Resorts World Sentosa is home to several amazing experiences. Take a movie-themed ride at Universal Studios Singapore, or immerse yourself in aquatic adventures at the S.E.A. Aquarium.
• Marina Bay: If you wish to explore the extravagant side of Singapore, visit the stunning, Marina Bay. The Nightlife is amazing with glittering lights, glitzy rooftop bars, and restaurants. Marina Bay is the central and the busiest district of Singapore.
• Chinatown: You can experience an impressive blend of traditional and modern Singapore in Chinatown. There are ornate Chinese, Buddhist and Hindu temples, museums and plenty of opportunities to soak up the busy streets which are full of old shophouses. It is the perfect location for traditional cuisine and you will be spoilt for choice.
• Orchard: The 2 km long Orchard Road is a shopper’s paradise as you will find large shopping malls and designer’s stores. Singapore’s only UNESCO World Heritage site, the Botanical Garden lies at the corner of Orchard Road.
• Joo Chiat: This neighborhood is more residential and you will find an amazing range of housing options.
• Little India: is the center of the Indian community within Singapore and is filled with multicolored shop-houses that line the streets, and various mosques and temples, and enjoy the aromas that infuse the night air when the demand for food is at its peak.

Weather and Climate in Singapore

Singapore lies close to the equator in the Southern Hemisphere. The island country has a tropical climate. It is hot and humid throughout the year which has led to a steady inflow of tourists all year round.

Singapore receives an annual rainfall of 2430 mm. An average of 167 days receives moderate to heavy rainfall. Two different monsoons: Northeast (December to March) and Southwest monsoon (May to September) accounts for the rainfall. Thunderstorms are quite common during the Southwest monsoon.

The average temperature is 31°C during the day. It is most likely that the temperature can drop to 19°C during the hours of darkness.

Getting around in Singapore

Rated as the world's best airport by Skytrax, Singapore Changi Airport is one of the busiest airports in the World. The airport serves around 100 airlines, flying to 400 cities across 100 countries. You can hire a taxi or use the MRT to reach downtown Singapore.

The transport system is efficient due to the systematic and comprehensive network of roadways. The Land Transport Authority controls private vehicles and minimizes traffic congestion. Some of the common forms of transportation are:

• Mass Rapid Transit (MRT): The MRT has a total of five lines. You can buy a Singapore Tourist Pass or EZ Link card which allows you to use the railways any number of times for two or three days. A single journey costs 0.58 USD and a train arrives every 2-3 minutes during the peak hours.
• Public buses: There are over 300 public buses to serve the locals and tourists and bus fares range from 0.58 USD to 2.07 USD.
• Taxis: are widespread in Singapore and are less expensive and metered. It can cost you 2.63 USD per km.
• Water taxis: Will take you across the beautiful River Singapore. You can visit a few tourist spots via water taxis and view the downtown from a different angle. A single journey will cost 5 USD.

Tourist Visa in Singapore

Citizens of India, China and Russia require a valid tourist visa to enter the territory of Singapore. The visa processing time is just 5 days and it is valid for 90 days from the date of issue. You are allowed to stay here for a maximum of 30 days.

People from the European Union, US, Norway, South Korea, Australia, and New Zealand can enter and stay for 90 days in Singapore visa-free.

Additional Information

1. Singapore dollar (S$) is the official currency of Singapore. 1 USD is equivalent to 1.36 Singapore dollars.
2. You can find ATMs close to banks, shopping malls and almost every tourist location. You can also pay by using credit and debit cards.
3. Malay is the national language of Singapore. Mandarin, English, Malay, and Tamil are the four other official languages of the country. So, almost all the locals are fluent in English.
4. Singapore is home to 10 religions. 33% of the total population practice Buddhism, followed by Christianity and Islam.
5. New Year's Eve, Chinese New Year, Labour’s day, Good Friday, Deepavali, Vesak day, Hari Raya Puasa and Christmas are some of the public holidays in Singapore.