Neurology

Neurology is concerned with diseases of the nervous system.
These include circulatory disorders of the brain, seizure disorders, headaches and facial pain, inflammatory diseases of the nervous system, sleep disorders, dementias, spinal disorders – especially disorders of the intervertebral disc, painful diseases of the peripheral nervous system (neuropathies), dizziness, movement disorders and muscle diseases.

The brain is a very active organ with a particularly high oxygen and energy demand. It accounts for only 2% of the human body weight, but about 20% of a human’s total amount of blood needs to flow through the brain every minute (cardiac output per minute). It uses more than 50% of the sugar released in the blood, which serves as energy supplier. Since it has very little storage capacity for energy, even a short-term supply failure leads to considerable brain damage.

It is especially important to me to have enough time for a thorough conversation with the patients and their relatives in order to record the medical history and to initiate the appropriate therapeutic measures.

Read more about the tasks of the neurologist...

Tasks of the neurologist

  • Detailed anamnesis and neurological examination
  • Diagnostics
  • Therapy
  • Aftercare

Following diseases:

  1. Circulatory disorders of the brain (stroke)
  2. Headache and facial pain
  3. Seizure disorders
  4. Movement disorders
  5. Dizziness
  6. Inflammatory diseases of the nervous system (e.g. multiple sclerosis)
  7. Sleep disorders
  8. Spinal disorders
  9. sPainful diseases of the peripheral nerves (neuropathies)
  10. Dementias

Dr.Mag. Robert Stepansky

 

A careful and individual clarification is self-evident to me. This is why I would like you to plan about 45 minutes for the initial examination.

 

 

More information about Dr.Mag. Robert Stepansky.

Sleep disorders

 

The sleep disorder is besides headache and dizziness the most common neurological symptom. Nevertheless, very few people talk to their doctor about it. After an accurate diagnosis, a targeted therapy is possible.

There are different forms of sleep disorders:

  1. Insomnias (Sleeplessness)
  2. Hypersomnias (increased need for sleep, e.g. narcolepsy)
  3. Parasomnias (e.g. sleepwalking, nightmares)

Dementias

There are different types and causes of dementia. The most common is senile dementia of the Alzheimer type (about 55% of all dementias).

Other forms of dementia:

  • Vascular dementia (e.g. after a stroke)
  • Parkinson’s disease dementia
  • Secondary dementias (e.g. in organ or systemic diseases)
  • Pseudo-dementia (e.g. in depression)

Learn more about the warning symptoms of Alzheimer’s disease dementia...

Warning symptoms of Alzheimer’s disease dementia:

  1. Forgetfulness (especially names, number, etc.)
  2. Mislaying of objects (e.g. house keys)
  3. Reduced ability to judge
  4. Difficulties in everyday activities
  5. Spatial and temporal disorientation
  6. Poverty of speech
  7. Change in mood and behaviour

Headache

There are different types of headaches. It is important to find out what type of headache it is in order to be able to offer a targeted treatment.

Headaches can occur as an autonomous condition (primary headache, e.g. migraine) or as a result of another condition (secondary headache, e.g. in meningitis or tumours of the brain).

Read more about the various types of headache...

Types of headache:

  • Migraine
  • Tension headache
  • Cluster headache
  • Headache due to excessive use of medication
  • Secondary headache
  • Facial pain

95% of headaches can be diagnosed on the basis of the anamnesis (= medical history).

Dizziness

Dizziness is not an independent disease, but a major symptom of various syndromes. Next to headaches and sleep disorders, dizziness is the most common neurological symptom. A low blood pressure can also lead to attacks of dizziness.

Dizziness can manifest itself in the impaired function of the eye muscles (nystagmus), the inclination to fall as well as nausea and vomiting.
Dizziness arises most frequently in inner ear diseases as well as brain or eye diseases.

The most frequent, very intense, but at the same time most treatable form of dizziness is the benign paroxysmal positional vertigo which is caused by mobile particles of tissue in the posterior semicircular canal of the vestibular system.

Movement disorders

Parkinson’s disease most commonly causes movement disorders. Parkinson’s disease is a common disease by which every 500th person of the population is affected. It was first described by James Parkinson in 1817.

Main symptoms of Parkinson’s disease...

The disease includes 3 cardinal symptoms:

The first is “reduction of mobility” or immobility (hypokinesia), which consists of the slowing down of movement, limitation of the range of motion and the reduction of spontaneous movement.

The second cardinal symptom is rigidity (rigor), which prevents fast movements.

The third cardinal symptom is tremor at rest (tremor), which has also caused this disease to be called by the German term “Schüttellähmung” (shaking palsy).

Stroke aftercare

Patients who were hospitalised in a neurology department due to an acute stroke should conduct regular follow-up visits.

This mainly affects patients with the following diagnoses:

  1. Ischemic attack
  2. Transient Ischemic Attack (TIA)
  3. Intracranial haemorrhage (ICH)
  4. Subarachnoid haemorrhage (SAH)
  5. Cerebral venous thrombosis (CVT)
  6. Transient global amnesia (TGA)
  7. Cerebral vasculitis (rare)
  8. Migraine associated stroke (rare)
  9. Dissections
  10. Other rare causes, e.g. Moya Moya disease

Learn more about aftercare and treatments...

Following a clinical check-up, further counselling is given regarding risk factors, especially high blood pressure, elevated blood lipids, diabetes mellitus, smoking and lack of exercise. We will discuss ways of lifestyle modifications and possibly make therapy changes.

On this occasion, there is enough time to discuss and answer questions as well as problems which might arise at home after being discharged from the hospital. Possible necessary therapies (physiotherapy, ergotheraphy, logopedia, neuropsychological training) can be prescribed as well.

In case there are still some pending examinations to clarify the cause of the stroke or check-ups which should be carried out, these will be initiated (e.g. ultrasound of the cervical arteries).

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