Neurology in Tokyo

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 Tokyo?

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 Tokyo 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 Tokyo

About Tokyo

Tokyo is Japan’s capital. It is one of the 47 prefectures of the country. There are over 13.9 million people estimated to live there. The capital is a giant metropolis that offers tourists the chance to indulge in the traditional Japanese culture, eat in one of its delicious restaurants, or learn more about modern life. One of the most popular sights in Tokyo is the cherry blossoms that fill the streets and parks with pink petals in Spring. The soft pink petals are an icon of the country.

Among the 30 million people who traveled to Japan in 2018 are medical tourists. With a vast range of high-quality medical services and facilities, Tokyo has a large contribution to the country’s growing medical tourism. it has numerous public and private hospitals that offer outstanding healthcare. These hospitals are equipped with cutting-edge medical technology and highly qualified doctors. Many doctors and medical professionals speak fluent English.

As Japan was ranked the highest in five-year survival rates of lung cancer and esophagus cancer patients from 2010 to 2014, the most sought-after medical procedure is Tokyo oncology treatments. There are many medical facilities in the area that are JCI-accredited and offers a wide range of treatments including Breast Augmentation procedures.

Popular Areas in Tokyo

Tokyo is sprawling with many extraordinary attractions and sights. It is the perfect mixture of traditional and modern. From temples, shrines, futuristic infrastructure, robot restaurants, booming nightlife, nature to anime, all coexist peacefully here.

To see a beautiful city view, climb up the Tokyo Skytree, Tokyo Metropolitan Government Building, and Tokyo Tower. Visit Tokyo’s oldest temple, Sensoji Temple in Asakusa, and learn more about the history and traditions. The temple is surrounded by numbers of Japanese restaurants that serve authentic dishes including Sushi, Tempura, and Sukiyaki. Tourists can also try a variety of traditional activities like wearing a Kimono dress.

Not far from Asakusa is Ueno, where one of the biggest parks in Tokyo is located. Ueno Park is the perfect place to spend a beautiful day. The park consists of a zoo, museums, historical monument, and green spaces. To try out Tokyo’s futuristic and modern side, come to the first digital art museum in the world, MORI Building DIGITAL ART MUSEUM — teamLab Borderless. Experience a unique interactive art with the latest technology and immerse in multiple digital art exhibitions.

Shopping is also one of the main attractions in Tokyo. Tourists most favorite places to shop are Ginza, Nakamise Shopping Street, as well as Takeshita Street and Omotesando in Harajuku. For anime or Disney fans, attractions such as Ghibli Museum, Fujiko F Fujio Museum, Pokemon Center, Tokyo One Piece Tower, Nakano Broadway, Akihabara, Tokyo Disneyland, and Tokyo Disney Sea are some of the best places to visit.

Weather and Climate in Tokyo

Tokyo is a year-round destination because it has temperate weather with four distinct seasons.

• Summer is hot and humid with an average temperature of 21 to 32 °C. Sometimes it can get as high as 40 °C. this season starts in June and ends in August. June sees a lot of rainfall while August is the start of typhoon season.
• Autumn lasts from September to November. The typhoon season peaks in November. The weather during this season is mild with less humidity. It is pleasantly warm in October, making it one of the best times to travel in Tokyo.
• Winter comes in December and lasts until February. The weather is dry and sunny with an average temperature of around 2 °C to 12 °C. The temperature rarely drops below 0 °C. There is very little snow in Tokyo.
• Spring starts in March to May. The temperature increases gradually during this season, with an average of 13 °C in the afternoon and 5 °C in the morning and evening. The sky is mostly clear during this season and it is also one of the best times to visit Japan because of the cherry blossoms.

Getting Around in Tokyo

Located around 60km east of central Tokyo, Narita International Airport is the main international gateway to Tokyo. The airport serves both domestic and international flights to almost every major city in the world. Budget airlines such as Jetstar Japan, Peach, and Eastar Jet operates flights from this airport.

Rail, bus, taxi, or car rental are available for tourists to reach the city center from Narita Airport. There are several train types to choose from. The Main Line (regular commuter train) in Keisei Line is the most affordable one, it costs around ¥1,190 to ¥1,230 ($10 to $11.3) and it connects with the Toei Asakusa Subway Line and the Yamanote Line. For faster travel, choose the Skyliner train that takes only 36 minutes to Nippori. This train costs around ¥2,470 ($22.7). There is another train known as the Sky Access Express train that offers better access to Tokyo. A trip to Asakusa takes about 58 minutes and costs around ¥1,290 ($11.9).

A taxi might not be the best option since it’s very expensive, it usually costs over ¥20,000 ($184) from Narita Airport to Tokyo. The more affordable option is the shared minibus which cost ¥6,180 ($57) per person. Buses are comfortable, the Limousine Bus costs around ¥2,880 ($26.5) and the Tokyo Shuttle costs around ¥900 ($8) to ¥1,000 ($9).

Tokyo is served by one of the best public transport systems in the world. Trains and subways are the best way to get around the city. It is the cheapest and fastest mode of transportation. Taxis are easily available and can be hailed on the street except in areas like Ginza, where taxis are only allowed to stop in taxi stands. The base fare is ¥430 ($4) for the first 1.5 km and ¥80 ($0.7) for every 237 meters.

Tourist Visas in Tokyo

Japan allows citizens of 68 countries and territories to stay in the country for up to 90 days. Citizens of Indonesia, Brunei, and Thailand are granted a 15-day visa-free trip. The country has a visa for a medical stay that grants long-term stays to medical tourists and approval for visa holders to travel back and forth between their home countries and Japan. Foreign visitors who visit Japan on tourist visas can also receive medical services, except for long-term therapies and surgeries that require more than three months.

Additional Information

1. Local Currency: The official currency is the Japanese Yen (¥). There is around ¥111 per $1.
2. Money & Payments: ATMs are widely available and can be found in post offices or convenient stores (especially 7-Eleven). Credit cards are accepted in some hotels, restaurants, and shops but it is advisable to always bring cash. Tipping is optional.
3. Local Language: Japanese is the official language. Most people speak limited English but many restaurant menus and signs are written in both Japanese and English.
4. Local Culture and Religion: The main religion is Shintoism and Buddhism. There is a small group of Christians in the city.
5. Public Holidays: There are sixteen major public holidays in Japan. The city hosts annual festivals including Fuji Matsuri, Hinode Matsuri, and Tenno Matsuri.