Neurology in South Africa

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 South Africa?

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 South Africa 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 South Africa

About South Africa

South Africa is home to some of the world's most luxurious private game reserves and lodges. Wildlife lovers come here from all corners of the globe in search of the "Big Five": lion, buffalo, leopard, rhino, and elephants. Coral reefs, shark dives, dragon-backed mountain ranges, white-water rafting, and golden beaches lapped by legendary surf breaks are some of South Africa's many other attractions. Traveling around this vast land and touring the vibrant cities, visitors can learn about the nation's turbulent history. Travelers coming to South Africa for medical treatments do so for cost savings, advanced medical technology, and the internationally qualified and skilled doctors. The country welcomes an ever-increasing number of medical tourists each year, many of which travel for Neurology procedures. Medical Tourists travel from all across the globe, particularly from African countries with an inferior healthcare system. Popular destinations include the capital city, Pretoria, neighboring Johannesburg, and the stunning Cape Town.

Popular Parts of South Africa

With more than 57 million inhabitants, South Africa is the world’s 24th most populous nation. It is a multiethnic society with a large variety of cultures, languages, and religions. Known for its exhilarating outdoor adventure, fascinating wildlife, magnificent landscapes, and opulent history makes South Africa a truly magical destination

• Cape Town is the oldest city and the legislative capital of South Africa. This pleasant city has a lot to offer as you can Hike the Table Mountain, take a wine tour, cruise to Robben Island, relax on beautiful beaches, visit District Six Museum, discover Kirstenbosch Botanical Gardens, and watch the Boulders Penguin Colony or shop in trendy markets. 
• Johannesburg is the largest and the most populous city. It is changing rapidly into an ultra-modern metropolis. Other than being an urban city, it also boasts a rich history. Tourists can visit the Apartheid Museum to learn more about the country’s difficult past through exhibitions. Other museums such as MOAD and MuseuMAfriCA are also worth a visit to view the city’s art and history.
• Durban is a cosmopolitan city with sunny beaches and charming Afro-Indian culture. There are more Indian nationals residing in this city than any other country outside of India. It is the place to go if you want to see marine life. Visit uShaka Marine World where you can snorkel, dive, and interact with animals. 
• Pretoria is a scenic city and you will find various historic buildings with astounding architecture such as the Voortrekker Monument, Union Buildings, and Church Square with its statue of Paul Kruger. Those who are looking for some outdoor activities can explore Pretoria National Botanical Garden and Rietvlei Nature Reserve for some wildlife viewing.
• Kruger National Park is one of the largest national parks and one of the most exciting safari destinations in the world. Here you can view all of Africa’s safari species such as Lion, Elephant, Rhino, Leopard, Buffalo, Hippo, and Giraffe along with more than 100 mammal species and 500 varieties of bird.

Weather and Climate in South Africa

South Africa’s climate is determined by its situation in the Southern Hemisphere’s subtropical zone and between the Atlantic and Indian Oceans. The country is a year-round destination thanks to its varying regional climates. May to September is the Dry Season with little to no rain. The days are mostly sunny, but it gets cold in the evenings and mornings. The average temperature during this season is around 14 °C with June to August as the coldest months. The wet season starts in October and ends in April. There will be occasional short rain showers in the afternoon. The average temperature during the wet season is around 20 °C, but it can also be as high as 35 °C, especially in December, January, and February.

Getting Around in South Africa

The main and the busiest airport in South Africa is the O.R. Tambo International Airport. The airport is located in Kempton Park, near Johannesburg and Pretoria. It serves as the primary domestic and international gateway to and from South Africa. The airport operates flights to other cities in South Africa as well as numerous major cities in the world including London, Singapore, Sydney, Abu Dhabi, and Atlanta. There are also two other major international airports: Cape Town International and King Shaka International. The inexpensive way to travel around the country is by flying with budget airlines such as FlySadair, Kalula.com, and Mango.

South Africa has an excellent infrastructure and is easy to navigate. However, if you wish to visit several cities, expect to have at least one long-distance trip. You can travel around by bus, train, or rental car. There are several long-distance bus companies you can choose, such as Intercape, Translux, and Greyhound. The buses are relatively affordable and safe. They are generally equipped with air-conditioning and an onboard toilet. For short-distance travel, Baz Bus is the best choice. A one-way ticket fare starts at around 500 ZAR.

Although trains are slow, they are less expensive than flights and more comfortable than buses. Shosholoza Meyl long-distance trains serve Cape Town, Johannesburg, Durban, Bloemfontein, and several other major cities. This train is very affordable with tickets costing as low as 400 ZAR for a sleeper train. If you’re looking for a more luxurious train, try the Blue Train which offers comfortable compartments, good food, and wine for around 18,300 ZAR. 

Taxis are available to get around major cities. Tourists can hail one directly from the streets. However, since the taxi ranks are not common, it is best to call for one. The base fare can be different in every city, ranging between 11 ZAR to 20 ZAR. 

Tourist Visas in South Africa

A valid visa is required if you wish to visit South Africa. Citizens of more than 60 countries can enter and stay for up to 90 days. Other countries not listed in the visa exemption agreement must apply and obtain a visa to the nearest South Africa embassy or consulate. All visitors must hold a passport valid for at least 30 days after the expiration of their intended visit, and the passport must have at least two unused pages. 

Additional Information

1. Local Currency: South African Rand (ZAR) is the official currency. 1 USD converts to 14 ZAR.
2. Money & Payments: Tourists can find ATMs all around the country. Credit Cards are widely accepted. However, since South Africa has a reputation for scams, you should inform your bank about your travel plans to avoid declined transactions. It is also advisable to always bring some cash with you. Tipping is expected here and you can tip around 10% to 15% of the bill in restaurants and cafes and the standard tip in hotels is 10 to 20 ZAR. 
3. Local Language: There are 11 official languages in the country, including Zulu, Xhosa, Afrikaans, Northern Sotho, Tswana, Southern Sotho, Tsonga, Swazi, Venda, Southern Ndebele, and English. Zulu is the most widely spoken language.
4. Local Culture and Religion: As a secular state, South Africa has a diverse religious population. Most of the population follows Christianity. Other religions such as the traditional African religion, Islam, Hinduism, and Judaism are also freely practiced.
5. Public Holidays: The country has 12 public holidays such as New Year’s Day, Good Friday, Freedom Day, and Christmas Day.