Neurology in Tunis

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 Tunis?

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 Tunis 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 Tunis

About Tunis

Tunis is the capital and the largest city of Tunisia and is the center of government and administration as well as the center of commercial and cultural activities. It is divided into two parts, the old city known as Medina and the new city or Ville nouvelle. Even though it is located on the southern shores of the Mediterranean Sea, the city does not have many beaches. Still, it has managed to attract millions of tourists in 2018 thanks to its rich history displayed in numerous ancient buildings. These buildings have an enchanting blend of North African and French Architecture that will leave anyone in awe. Many tourists come to see the Roman ruins of Carthage or to stroll around and shop in the Medina.

Tunis is known to have a high standard of healthcare, which attracts an increasing number of medical tourists each year. Many of the medical tourists come from other African countries that have an inferior healthcare system. However, the city’s excellent reputation in cosmetic surgery and dental treatment appeal to many patients from Europe, the Middle East, and Asia. The private medical centers are armed with the best equipment and English speaking staff. The Tunisian Ministry of Health regulates cosmetic and plastic surgeons to ensure that there is a high standard. In addition to exceptional healthcare, Tunis also offer attractive prices for medical treatment and the cost of living. 

Popular Areas in Tunis

Although it is the largest city in Tunisia, Tunis can feel like a compact city and can be explored on foot. The city has a number of famous attractions that are always packed with tourists.

• Carthage was founded in the 9th century BC and was once a powerful empire of the Mediterranean as well as home to a wonderful civilization before being destroyed by the Romans in the Third Punic War. It was then to become an important Christian center until the Islamic invaders destroyed it. Today, the ruins have become a UNESCO World Heritage Site that tourists can visit.   
• The Medina in Tunis is one of the most remarkable medieval medinas in North Africa. There are over 700 monuments within the area, from mosques to madrassas to historical places. It is easy to get lost in the impressive maze-like alleyways, but tourists are encouraged to admire the Islamic architecture and art or learn more about the city’s history. Tourists can also shop in one of the souqs selling everything from shisha pipes to shoes or enjoy one of the cafes.
• Sidi Bou Saïd is a picturesque cliff-top village with cobbled streets, blue-and-white walls, and glimpses of pristine blue waters. It is probably one of the most beautiful places in Tunisia. The beautiful architecture is a blend of the Ottoman and the Andalusian. It is now a sleepy fishing village perfect for anyone who wants to get away from busy city life. The village has been a gateway for artists, bohemians, and pilgrimage for centuries.
• Bardo Museum is the second-largest museum in Africa and the main attraction of this museum is the ancient Roman mosaics recovered from Carthage. The museum also exhibits Greek statues, artifacts of the region’s Berber, and the accomplishments of the Islamic culture in the country. Other than the exhibitions, the building itself is decorated in impressive historic Islamic decorative arts.

Weather and Climate in Tunis

Tunis has a hot-summer Mediterranean climate meaning the city enjoys warm and sunny weather all year round. The summer can be hot and dry because rain is very rare and the summer usually lasts from June to August and the average temperature is around 25 °C but can get as high as 40 °C. July and August are the high tourist season, especially at the beach resorts. The city begins to get rain in autumn, often accompanied by a short thunderstorm. The winter is the wettest season of the year because it can rain every two or three days and the temperature can drop to 7 °C in the morning and 16 °C in the afternoon. The rainfall decreases in spring, and in March, the temperature ranges between 8 °C to 24 °C and the sunshine usually becomes dominant in May.

Getting Around in Tunis

Tunis-Carthage International Airport is the main airport in Tunisia and the airport connects Tunis with other cities in the country as well as the rest of the world as it serves flights to and from the Middle East, Africa, and major Europeans countries. It is the hub for Tunisair, Tunisair Express, and Nouvelair, but there are not many budget airlines operating flights from the airport. To get to the city center from the airport, tourists can opt for a taxi or bus. The bus is operated by the SNT bus line and departs every 30 minutes. It is very affordable with a single ticket costing less than 1 TND. There is also a more luxurious and expensive bus line known as the TUT bus and the bus departs every 15 minutes. If you want a more private mode of transportation use an airport taxis and they are usually metered.

Tourists have plenty of options to get around Tunis. There is a tram system in the city with inexpensive tickets, usually around .48 TND. However, be aware that it can be packed during the rush hours. Taxis are a good option to get around, the taxis are metered, and the base fare is around .4 TND but can be much more expensive if you hail one off the street. 

Tourist Visas in Tunis

Nationals of 97 countries including Australia, China, Singapore, the United States, and Russia can enter and stay in Tunis for up to 90 days without a visa. Other nationalities not listed in the visa exemption agreement are advised to check at their nearest Tunisia embassy or consulate. The country provides an online visa application to simplify the process of obtaining a visa to enter the country.

Additional Information

1. Local Currency: Tunisian dinar (TND) is the official currency of Tunisia. 1 USD will get you 2.61 TND. 
2. Money & Payments: ATMs are widespread in Tunis. Credit Cards, particularly MasterCard and Visa, are accepted in most top-end restaurants, hotels, and shops. Tipping is by no means mandatory but will be greatly appreciated.
3. Local Language: Arabic is the official language and French is very common. English is not widely spoken except in tourist areas and hospitals.
4. Local Culture and Religion: Most of the population follows Islam, but there are small groups of Christian and Jews.
5. Public Holidays: The city celebrates major nationals and Islamic holidays such as Independence Day, Eid Al-Fitr, and Prophet Mohammed’s Birthday.