Neurological disorders include disorders of the brain, the spinal cord, the peripheral (arm and leg) nerves, including their nerve roots, but also disorders of the muscles.
Frequent complaints include:
Headache, facial pain
Dizziness, vertigo and balance disorders
Blurred vision and double vision
Epileptic seizures, sudden falls and disorders of consciousness
Movement disorders such as gait disorder, coordination disorders, trembling or "restless legs"
Sensory disturbances (tingling sensation, numbness)
Speech and swallowing disorders
Memory and cognitive disorders
Muscle weakness, unexplained muscle pain and paralysis
Identical neurological complaints can have various causes. An exact classification of the underlying disease is imperative to provide you with expert advise about the expected course of the disorder, and especially about possible therapeutic measures.
Frequent neurological diseases are:
Headache and facial pain
Various reasons can be differentiated already from one another by a thorough medial history. Common reasons are: tension headache, migraine, cluster headache, medication overuse headache, trigeminal neuralgia. It is important to discriminate these headache causes of others, in parts very serious headache reasons (brain tumor, inflammation, cerebral haemorrhage).
Disc prolapse with irritation of the nerve root
Disc herniations are usually associated with severe pain. The pain, which often emanates in the arm or the leg, is an expression of the irritation of the nerve root affected by the herniated disc. If motor and / or sensory failure phenomena occur in a temporal connection with a disk herniation, that is, significant paralysis of single or multiple muscles or a stronger numbness, rapid neurological clarification is important, e.g. to assess the need for surgery.
Disorders of peripheral nerves
Damage to peripheral nerves can be caused by anatomical narrowing (so-called entrapment syndromes), particularly the carpal tunnel and cubital tunnel syndrome, as well as meralgia paraesthetica (compression of a skin nerve at the frontal aspect of the pelvis).
Disorders of the nerve metabolism, for example in the context of a diabetes mellitus, a vitamin deficiency but also by inflammatory processes often lead to polyneuropathies, states in which several peripheral nerves are affected.
Circulatory disorders of the brain can lead to permanent (cerebral infarction, cerebral haemorrhage) or transient (transient ischemic attack, TIA) neurological symptoms which typically occur suddenly. An acute stroke is always an emergency and an immediate treatment in a stroke unit is necessary. I will be happy to help you with stroke prevention as well as with post-stroke care.
Inflammatory diseases of the central nervous system
Inflammatory processes of the central nervous system may be caused by autoimmune phenomena, in which multiple sclerosis (MS, encephalomyelitis disseminata) is the most frequent form; other reasons for example include neurosarcoidosis, neuromyelitis optica spectrum disorders, and certain forms of vasculitides. Alternatively, infections (bacteria, viruses) can lead to inflammatory/infective diseases of the central nervous system (e.g. neuroborreliosis, virus encephalitis).
Epileptic seizures, disorders of consciousness
Epileptic seizures with their various forms of expression ("focal seizures", “generalized seizures") can be the triggered by various diseases of the brain. Frequently, long-term, even life-long medication is necessary to avoid further epileptic seizures. Epileptic seizures have to be discriminated from other causes of disorders leading to sudden and temporary unconsciousness, e.g. syncopes or psychogenic / dissociative seizures.
Movement disorders, Parkinson's disease
In addition to classical Parkinson's disease ("Morbus Parkinson", Idiopathic Parkinson's syndrome (IPS)), other neurodegenerative diseases also lead to movement disorders which may be similar to Parkinson's disease, e.g. Progressive Supranuclear Paralysis (PSP) or Multisystem Atrophy (MSA). Gait disturbances can also be caused by vascular diseases, in particular by cerebral microangiopathy or a normal pressure hydrocephalus. An isolated tremor is also found in essential tremor, a disease that is often hereditary. The Restless Legs Syndrome (RLS), which occurs mainly in resting phases, is considered a disturbance of movement in a broader sense.
Dementia, Neurodegenerative Diseases
Alzheimer's disease and vascular dementia are by far the most frequent underlying reasons for dementia. Dementia can also occur in the context of advanced Parkinson's syndromes. Other neurodegenerative diseases go along with other complaints, in the case of amyotrophic lateral sclerosis (ALS) progressive muscle weakness is prominent, in degenerative cerebellar atrophy balance-disturbances and uncoordinated movements (ataxia) are present.
Muscle diseases, myopathies, neuromuscular diseases
Muscular diseases usually manifest by an increasing weakness of one or more muscles. Autoimmune-inflammatory, rare pathogen-causing or genetic disorders are the cause of these diseases. Furthermore, medication induced forms of myopathies (statin myopathy, steroid myopathy) exist.
Myasthenia gravis and the Lambert-Eaton myasthenia syndrome (LEMS) are caused by an autoimmune-related disorder at the neuromuscular junction (connection between the motor nerve and muscle fibers), without the muscle being affected directly.
Functional disorders, somatoform disorders
Functional or somatoform disorders are conditions in which physical complaints, however, have no organic cause. In these cases, psychiatric / psychological evaluation is often useful in order to properly diagnose, classify and treat a potentially underlying psychological disease.
Persistent or recurring vertigo often has a neurological cause, which can usually be classified well by means of an exact medical history, physical examination and, if necessary, additional diagnostic methods. The most common cause of vertigo is the benign paroxysmal positional vertigo (BPPV), characterized by motion-dependent, short rotational vertigo. Vestibular migraine and vestibular neuritis also go along with rotational vertigo, while other diseases (bilateral vestibulopathy, persistent postural-perceptual dizziness) are characterized by dizziness rather than vertigo.