Neurology in Thailand

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 Thailand?

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 Thailand 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 Thailand

About Thailand

Thailand is consistently voted one of the most popular travel destinations in the world, leading the way for Asian countries with over 60 state-of-the-art JCI-accredited facilities. The country is renowned for its tropical beaches, floating markets, stunning royal palaces, and Buddhist temples. The vibrant capital, Bangkok, blends tradition and modernity with its ultramodern cityscape featuring brand-new high-rise condominiums side-by-side with quiet, serene canalside communities. As per the Tourism Authority of Thailand, Phuket, Koh Samui, Chiang Mai, Hua Hin, and Pattaya are the most sought-after tourist spots outside Bangkok, each boasting excellent yacht chartering opportunities.

Each year, Thailand opens its doors to hundreds of thousands of medical tourists. These individuals traverse the globe to receive treatment, with a significant number hailing from the local SE Asia region, Australia, the United States, and the Middle East. Recently, there has been an upsurge in the number of visitors coming in from China for medical purposes. 

The reasons for Thailand's popularity as a medical tourism destination are its outstanding private healthcare system, attractive tropical climate, and competitive pricing. In the list of top medical tourism destinations worldwide, Thailand currently holds the third position. The procedures that attract most patients are cosmetic surgeries, including breast augmentations, gender reassignment surgery, and CoolSculpting, along with cardiac surgery, orthopedics, and urology.

Popular Parts of Thailand

Thailand, with a population of just under 70 million people spread over an area of around 500,000 square kilometers, has several regions and cities that are widely popular with both natives and tourists. Offering a diverse blend of urban and rural experiences, beach life and inland natural beauty, each part of Thailand offers a unique angle into the rich and complex Thai culture.

Arguably the most popular area of Thailand is the capital city, Bangkok. Consistently ranked as one of the most visited cities in the world, Bangkok is an ever-buzzing urban hub with its busy streets, modern lifestyle, magnificent temples and opulent palace, alongside a pulsating nightlife. This city is typically the entry gateway for a vast majority of the 30 million tourists who visit Thailand each year. Known for its glimmering cityscape and vibrant food scene, Bangkok is indeed a compulsory stop in every traveler's itinerary.

While Bangkok is the country's urban heart, there's more to Thailand than just its capital. Among the other popular regions are the beachside island paradise of Phuket and Koh Samui, the city of Pattaya, and Hua Hin - each of them a haven for beach lovers and anyone seeking a laid-back vibe away from bustling city life. However, for those who prefer the call of the inland and a dash of adventure, Chiang Mai, nestled in the lush jungles of northern Thailand offers a refreshing and unique proposition with its derivative local culture, serene temples and interaction with native wildlife.

Weather and Climate in Thailand

Known for its truly tropical climate and scorching temperatures, Thailand, in general, is hot and humid all year round. The coastal locations do benefit from the cooling sea breeze, a luxury urban Bangkok is denied. Average temperatures range from 28°C (82°F) up to 35°C (95°F). However, during the Hot Season (March to June), temperatures can top 40°C (104°F).

The infamous Rainy Season tends to start in July and continue through to October; during this time expect heavy rainfall, often amounting to flooding in some areas. It will remain warm to hot but humidity levels will rise and the mosquitos will come out to play!

November to February is often referred to as the Cool Season when less rain is expected and the temperatures tend not to rise above 35°C (95°F).

From a tourist perspective; the High Season lasts from November to March and the Low Season from April to October. But be aware of the Shoulder Seasons of April to June and September to October, when Thailand is less impacted by the Rainy Season and less busy with tourists – these can be the ideal times to visit.

In a nutshell, Thailand is a Shorts and T-shirt Country, you’re never really going to be cold, so pack light; shorts, t-shirts, vests, skirts, singlets, and light dresses. Maybe pack jeans and shoes if you’re planning on going to a swanky roof-top bar in Bangkok or to a temple where flip-flops are not acceptable.

Don’t forget mosquito spray as the little pests can get everywhere; big ones and little ones! Always protect against the sun; with high factor sunscreen and UV-protective sunglasses. The usual medications found at home should be available in most pharmacies.

Getting around in Thailand

With the Suvarnabhumi International Airport being serviced by some of the world’s major airlines, tourists can fly into Thailand from almost anywhere in the world, sometimes with a connection along the way. All the popular regions have their own international airports, with the exception of Pattaya, which is just a 90-minute taxi ride from Bangkok. However, arrival destinations are slightly limited outside of Bangkok, but the likes of Emirates and Qatar Airways will fly into Phuket International Airport. The rest, mostly fly in from local countries on budget airlines, including Scoot, SilkAir, AirAsia, and Lion Air to name a few.

For domestic flights, the airports are nicely linked in Thailand with flights from as little as $45 USD one way. There are several budget airlines servicing these routes, including Thai Lion Air, AirAsia, Nok Air, Thai Airways, Bangkok Airways, and Thai Smile.

The train allows for even cheaper travel within Thailand and is far more comfortable than spending hours sitting on a bus. Bangkok has the BTS, or Skytrain, which allows for fast transfer from the airport into the city. Given the traffic in central Bangkok, the BTS offers a great alternative to being stuck in traffic jams.

Taxis are great, however, be sure to confirm the price before you begin your journey or better still, insist the ride goes on the meter – that is how you guarantee the cheapest and fairest price. But expect traffic in the city and any built-up areas.

Tourist Visas in Thailand

Before you travel to Thailand, it is important to stay updated with the latest visa requirements. While a number of countries are eligible for visa-free entry, the rules can sometimes shift, making it essential to verify before you travel.

If you are travelling from countries like the United Kingdom, the United States, Germany, Australia, Singapore, Canada, France, Italy, Japan, New Zealand, and South Korea can enjoy a stay of up to 30 days in Thailand without needing a visa. On the other hand, if you are visiting from China, India, Myanmar, Laos, Cambodia, Bhutan, Nepal, Bangladesh, Sri Lanka, Pakistan, and Uzbekistan, you will be granted the facility of a visa on arrival.

To get a visa on arrival here are the requirements:
1. You need to have a valid passport with at least 6 months of remaining validity. 
2: You would need to show proof of a round-trip ticket within 30 days and confirmation of your accommodation for the first night in Thailand. 
3. You need to demonstrate that you have sufficient funds for your visit, which is 10,000 THB per person or 20,000 THB per family. 

Don't forget to carry a recent passport-sized photograph. The fee for a visa on arrival is 2,000 THB, and you can pay it via cash or credit card.

For more information, click here.

Additional Information

1. The Thai Baht (THB) is the local currency. 1 USD is approximately around 34.5559 on average as of  2023.
2. ATMs are readily available across Thailand and accept virtually all major bank cards (Visa, Mastercard). Credit card payment is accepted in most established restaurants and outlets, with the more local food vendors, for example, only accepting cash.
3. Thai is the local language but due to the extremely well-established tourism industry in Thailand, English is spoken by most locals who work with tourists, and often signs will have an English translation.
4. Buddhism is the primary religion in Thailand, with a large Muslim population in the south. The Royal Family is deeply revered throughout the country and should never be disrespected.
5. There are many public holidays in Thailand, which aren’t always on the same day each year, including Songkran (Thai New Year), which is celebrated in mid-April, Labor Day, and Coronation Day in early May, Asanha Buja in July and Constitution Day in December.