Neurologist

Initial consultation with a neurologist (neuropathologist)

During the initial consultation, the neurologist will ask questions about how you are feeling, perform a complete medical examination, make a preliminary diagnosis, and prescribe treatment to stabilize your condition until the test results are available. The neurologist will also determine whether urgent or elective hospitalization is necessary.

The most commonly diagnosed conditions during a consultation with a neurologist (neuropathologist):

• Disorders of the autonomic nervous system (autonomic-vascular dystonia);
• Diseases of the cerebral blood vessels (strokes, etc.);
• Migraine;
• Tension headaches;
• Neurological syndromes of the spine (osteochondrosis and others);
• Diseases of the peripheral nervous system (polyneuropathies, neuralgias, neuritis);
• Diseases of the muscles and neuromuscular transmission (myasthenia gravis, myopathy);
• Parkinson’s disease;
• Epilepsy;
• Multiple sclerosis and other conditions.

Follow-up Appointment with a Neurologist

Once the test results are available, a follow-up consultation with a neurologist is necessary. The neurologist will analyze the test results, conduct a follow-up examination, assess the progression of your condition, and make a final clinical diagnosis. During the follow-up consultation, the neurologist will prescribe the optimal treatment regimen for you and explain how to properly manage your condition. If you are in the post-stroke period, the neurologist will explain what to do if certain symptoms arise.

Some neurological conditions require monitoring, changes to the treatment plan, or adjustments. If it becomes necessary to monitor the progression of your condition, your doctor will let you know how often you need to come in for follow-up visits.

Additional tests that a neurologist (neuropathologist) may order:

• Electromyography (EMG);
• Electroneuromyography (ENMG);
• Electroencephalography;
• X-ray examinations;
• Duplex scanning of the neck/head arteries, transcranial Doppler;
• Computed tomography (CT) of the brain and spine;
• Magnetic resonance imaging (MRI) of the brain or spine, with or without contrast;
• Laboratory tests.

NERVE BLOCKS IN NEUROLOGY

This is one of the most modern methods for eliminating pain and other negative symptoms of various conditions.

Advantages:

1. Works extremely quickly
2. Has virtually no side effects.
3. Non-addictive; can be performed multiple times.
4. Has a comprehensive effect on the body.

Indications:

1. arthritis and osteoarthritis;
2. phantom pain;
3. severe headache and dizziness;
4. neuritis, including facial nerve neuritis;
5. neuralgia, including intercostal neuralgia;
6. spinal stenosis, osteochondrosis, and other spinal problems
7. plexopathy;
8. recovery from joint and spinal injuries.

Result:

1. the pain subsides, almost immediately;
2. relieves blood vessel constriction and excessive muscle tension caused by an injury;
3. reduces fluid buildup in tissues and adverse reactions in blood vessels;

Duration of the procedure: depends on the body area

Preparations: Kenalog, Depo-Medrol

Recommended course: 2–15 injections

Frequency: 2–3 times a week

 

Contraindications:

1. hemorrhagic syndrome or fever;
2. the tissues at the site of insertion are damaged by infection;
3. cardiovascular disorders and severe liver and kidney diseases;
4. individual intolerance to the preparations used;
5. the likelihood of exacerbations of peptic ulcers, diabetes, porphyrias, and other health conditions due to the effects of the imported substances;
6. serious central nervous system disorders.

What is a therapeutic block?

A therapeutic block is a modern treatment method for pain syndromes and other clinical conditions that involves the direct administration of medication into the pathological focus responsible for the pain syndrome.

The primary goal of the block is to eliminate the cause of the pain. Equally important is addressing the pain itself. This must be done fairly quickly and in a way that minimizes side effects and requires minimal resources and time—in other words, quickly and effectively. The blockade method meets precisely these conditions.

Raviblokaadi näidustused

The primary indications for therapeutic nerve blocks include pain syndromes caused by osteochondrosis of the cervical, thoracic, and lumbar spine; arthralgia; neuralgia; facial and headaches; VBI syndrome; postoperative and phantom pain; plexopathy; complex regional pain syndrome; and others. Pain blocks are also used in cases of Ménière’s disease, myotonic syndrome, trophic disorders of the extremities, and tunnel syndromes.

ADVANTAGES OF THE NERVE BLOCK METHOD

Rapid pain-relieving effect

The rapid pain-relieving effect of nerve blocks is due to the fact that the anesthetic directly reduces increased impulse transmission, primarily in the slow nerve endings of the nervous system through which chronic pain spreads. With other methods (electroneurostimulation, acupuncture, and other physical modalities), stimulation primarily occurs at fast nerve endings, which reflexively and indirectly inhibits the pain impulse; therefore, the analgesic effect occurs more slowly.

Minimal side effects

Medikamentoossel meetodil (tabletid, lihasesüstid) satuvad preparaadid kõigepealt vereringesse (kus neid pole nii väga vaja) ja alles siis vähesel hulgal haiguskoldesse. Blokaadi korral toimetatakse raviained otse patoloogilisse koldesse (kus need on kõige enam vajalikud) ja alles seejärel satuvad nad vähesel määral vereringesse.

Can be performed multiple times

During a nerve block, the anesthetic only temporarily interrupts the pain signal, while allowing other normal nerve impulses to pass through. However, repeated blocking of the pain signal—which originates from the pathological focus—enables a clearly pronounced and long-lasting therapeutic effect. Therefore, therapeutic blocks can be performed multiple times — each time an exacerbation occurs.

Comprehensive therapeutic effects

Blocks have a wide range of therapeutic effects. They eliminate local pathological muscle tension and vascular spasms, inflammatory reactions, and swelling for a long time. They restore impaired trophism in local tissues. Therapeutic blocks interrupt the pain impulse originating from the pathological focus and normalize the reflexes of the nervous system.

 

QUESTIONS

What should you do after the blockade?

For a few days after the nerve block, you should take it easy. Avoid excessive physical activity or lifting heavy objects. Some specialists recommend wearing a semi-rigid brace. This helps relieve pressure on the irritated segment of the spine and reduce pain. Once the pain has subsided (if it hasn’t gone away immediately), you can move on to the next stage of treatment. Don’t neglect manual therapy and therapeutic exercises—the nerve block relieves pain but doesn’t address the underlying cause, so there’s a high likelihood that the pain will return.

How often do I need to attend treatments during the course of treatment?

The interval between procedures is determined immediately after each intraosseous block and depends on the effectiveness of previous procedures and the severity of the pain syndrome. On average, intraosseous blocks are administered at intervals ranging from 2 days to one week.

How long does the effect of a single treatment last?

The duration of the therapeutic effect of an intraosseous block depends on several factors. First, following the doctor’s recommendations, maintaining a proper work-rest balance, regularly performing therapeutic exercises, and avoiding physical and emotional overexertion all play a crucial role. Timely completion of preventive treatment courses can completely prevent the recurrence of pain. Second, the severity and extent of the pathological process that led to the pain play a major role—the more severe the pathological processes, the shorter the duration of the effect is likely to be.