Neurology Centre

What is Neurology?

Neurology is a branch of medicine that examines, diagnoses and treats diseases related to the cerebrospinal cord, peripheral nervous system and muscles of the body.

Neurological diseases can affect all body systems. Because abnormalities in the electrical structure of the brain, spinal cord or nerves can cause many problems. Examples of these problems are stroke (paralysis), muscle weakness, coordination problems, loss of sensation, seizures, dizziness, pain and loss of consciousness.

Which Diseases Does the Department of Neurology Treat?

Brain-related diseases diagnosed and treated in our neurology department include;

• Headache,
• Migraine,
• dizziness,
• Sleep disorders (such as Sleep Apnea Syndrome, REM Behaviour Disorder, Restless Legs Syndrome),
• epilepsies,
• Multiple Sclerosis (MS) disease,
• Parkinson’s disease,
• Alzheimer’s and similar dementia (forgetfulness) diseases,
• paralysis,
• Neuropathies (diabetes-related, hereditary, toxic, neuropathies due to various diseases or drug use, etc.)

In addition, the psychological consequences of the diseases mentioned above are also evaluated and treated.

What are the Diagnosis, Examination and Treatment Services of the Neurology Department at Moodist?

Neurology physicians are interested in the diagnosis, follow-up and treatment of a wide range of diseases involving all parts of the nervous system and neuromuscular diseases. Neurological diseases can occur for many different reasons. In the diagnosis and follow-up of these diseases, tests measuring neural transmissions and some imaging methods are used. Before the diagnosis of patients with neurological problems is made, the patient’s past findings are examined by our neurologist.

A detailed family history is taken to understand whether there is a genetic disease or pre-existing diseases in the patient’s history. After the neurological examination, the cause or causes of the disease are investigated. In order to diagnose some problems, tests such as EMG, EEG, PSG are also carried out by our unit. The causes and conditions of diseases are investigated by using these and similar tests and blood analysis methods. In the light of this information, the most appropriate treatment methods are planned and applied to the patient. In summary

• Taking anamnesis (complaint and history),
• Neurological examination,
• Blood tests,
• Electrophysiological examination (EMG, EEG, PSG),
• Radiological examination (if necessary)

Some of the examinations and services applied in the neurology clinic of Moodist Hospital are as follows:

Moodist Electrophysiology Laboratory

In the diagnosis of many neurological diseases, electrophysiological tests may be required as well as examination. These tests are electroencephalography (EEG), electromyography (EMG), and polysomnography (recording of sleep and sleep-related breathing and movements). These tests are not just a group of laboratory tests, they are an extension of the neurology evaluation. They not only confirm or falsify the clinically suspected condition, but also reveal vague, silent, or previously unsuspected abnormalities, and allow to pinpoint the location, type, and extent of the abnormality. In general, with the exception of electrophysiological tests, pathophysiological changes and functions in the central and peripheral nervous system and musculature are measured and described.

EEG (Electroencephalography) 

Electroencephalography is the printing of electrical activity produced by nerve cells in the brain during both wakefulness and sleep as brain waves on paper. The electrical activity of the brain is measured by means of electrodes placed on the scalp. Examination methods developed later than EEG, such as computed tomography (CT) and magnetic resonance imaging (MR), do not provide information about the electrical activity of the brain. It gives information about the function of the brain at the time of recording. If there is a problem in the brain that disrupts the brain waves, it can give very limited information about the location of the problem and why it occurs. However, it does not give any information about the image of the damage in the brain.

It is mainly used in cases of suspected epilepsy and in the follow-up of epilepsy disease. The purpose of EEG in epilepsy is to support the diagnosis, decide on the treatment, determine the types (classification), investigate the focal brain lesion and monitor the epilepsy patients. However, it can be used for differential diagnosis in many cases (forgetfulness diseases, encephalitis, various systemic diseases and conditions with blurred consciousness due to drugs, etc.) that can cause loss of function in brain cells and disrupt brain waves.

The EEG test, which is used primarily to examine patients with epilepsy and suspected seizure disorders, can also be performed in our electrophysiology laboratory.
The electrical activity of the brain is transmitted to the EEG device through small metal electrodes placed on the scalp of the patient and the data is recorded on the computer for an average of 20 minutes. Electricity is not transmitted to the patient during imaging and the patient does not feel any pain.

EMG (Electromyography)

It is used to evaluate central nervous system (brain, spinal cord), peripheral nervous system and muscle functions. The EMG test is an electrophysiological test used to measure the disorders in the connections between nerves and nerves-muscles and is applied by neurologists. With EMG, it is tried to obtain information about the location, degree, type, and duration of the problem, if any, in these regions. Nerve conduction states and velocities of sensory and motor nerve endings are measured.

The most frequently used areas are diagnosis and treatment of diseases such as Trapped neuropathies such as Carpal Tunnel Syndrome (CTS), demonstration of nerve damage in low back and neck hernia, display of nerve-muscle transmission disorders in muscle diseases, facial paralysis, diabetes or various diseases, polyneuropathy due to drug-substance-alcohol use, motor neuron disease (ALS) or Guillain Barre Syndrome. In order to apply EMG, which is a very complex test, it is necessary to undergo long-term training.

Polysomnography (Sleep Test) (In Hospital and At Home)

It is a test in which sleep, breathing, movements in the arms and legs are recorded all night long. This test is most commonly used to detect sleep-apnea syndrome, sleep-related movement disorders, and sleep-related disorders. In Moodist hospital, the polysomnography test, that is, the sleep test, can be applied both in the hospital and at home.

Moodist Neuropsychology Laboratory

Neuropsychological evaluation; In addition to neurology, psychiatry and neurosurgery, it is one of the auxiliary examination methods that has an important place in applications in special fields such as epilepsy surgery and clinical psychology. This examination is carried out on the basis of the brain-behavior relationship, with a set of psychometric tools called neuropsychological tests.

Complex behaviours and cognitive functions occur depending on the activity of large-scale, scattered, neurocognitive networks in which certain anatomical structures in the brain and the neural networks between them participate. Damage to any component of these systems can result in mild or severe impairment in the relevant cognitive area. Neuropsychological tests, on the other hand, allow us to evaluate our complex behaviours and cognitive functions, which are the products of these neural systems. Neuropsychological tests are used for differential diagnosis, monitoring the disease, monitoring the effectiveness of treatment, planning rehabilitation and research.

Thus, neuropsychological tests are an effective tool at our disposal to reveal whether there is a real memory or other mental dysfunction or weakness underlying the person’s complaints, that is, to understand whether the event is really due to a deterioration in brain function or more like mental tension These tests also give clues about the type of disorder caused by the disease (ie the diagnosis of the disease) and the course of the disease by looking at the form of the disorder in cases where a mental disorder is detected.

In addition, the effectiveness of the applied treatment can be determined by a detailed neuropsychological evaluation before and after the treatment. The neuropsychological profile of the person, that is, the processes that are disrupted and preserved by the patient, are of great importance in determining the strategies to be used to compensate for the emerging disorders, in other words, in the programming of his rehabilitation. Mental functions evaluated with neuropsychological tests can be listed as follows:

• Alertness and Attention
• Complex Attention and Executive Functions, Perseverance,
• Resistance to interference, Ability to inhibit response, Change category
• Planning
• Abstraction, Reasoning
• Memory
• Language Skills
• Arithmetic
• Orientation of attention to space – Complex visual perceptual functions (Visual-spatial skills)
• Configuration (Visuo-constructive skill)
• Praxis

In the Moodist neuropsychology laboratory, standard and computerized neuropsychological tests are performed and interpreted by experienced clinical psychologists. As a result of all these mental skills evaluated, the reasons for the patient’s complaints and real problems can be revealed by the specialist and the physician who performed the test. As a result of the result, a suitable treatment program is determined for the patient and the necessary rehabilitation techniques are applied. Cognitive rehabilitation program is carried out for the cognitive skills of the patient, which are determined to be weak in the light of neurological and neuropsychological evaluations.

Difference of Moodist in Diagnosis and Treatment

Moodist Hospital Neurology Department provides outpatient diagnosis, treatment and follow-up services for a wide range of neurological diseases.

Research and study programs on newly developed techniques and treatment options are successfully carried out in our hospital. In this way, we are able to produce information on the one hand and present newly emerging treatment options to the service of our patients.

Within the scope of treatment, the treatment program of various diseases is created specifically for our patients. Thus, we adopt a much more effective treatment approach in our patients with drugs that are versatile and complementary treatment options, cognitive rehabilitation, brain stimulation methods and many techniques for reorganizing daily life activities. We have a multidisciplinary work team with a level of competence that can apply all this treatment approach we have adopted.

What Happens If Neurological Diseases Are Not Treated?

Neurological disorders are among the disease groups that create the highest health burden for patients, their relatives and healthcare professionals, and this situation is increasing with the aging world population. Neurological diseases are the cause of approximately 16.8 percent of deaths worldwide and 9.4 million people die each year in the world.

In brain and nerve diseases, as in other diseases, some physical pains or negative complaints are encountered. In this sense, if it is necessary to make an assessment of the symptoms of neurological diseases, patients usually consider seeking help from neurologists with the following symptoms and complaints:

• Headache
• Dizziness
• Syncope
• Sleeping disorders
• Tremors and involuntary movements of the hands
• Movement disorders
• Consciousness disorders
• Forgetfulness
• Waist, neck and back pain
• Loss of balance

When such symptoms occur, a neurologist should be consulted as soon as possible and evaluated together with some examinations. Rapid and early diagnosis is very important for neurological diseases that occur due to negativities in the autonomic, central and peripheral nervous systems, which constitute the most sensitive structures of our body in the vital sense.

Early diagnosis and initiation of treatment are also very valuable in terms of recovery. If the examinations and diagnosis are delayed, irreversible damages and even life risks may occur. For this reason, people with neurological disorders should immediately contact the nearest neurologist and start the treatment process immediately after early diagnosis.

Neuromodulation Laboratory

Transcranial Magnetic Stimulation (TMS) is a new tool and method that has started to be used in the treatment of some neuropsychiatric diseases. TMS application is performed in Moodist Hospital Neuromodulation Laboratory. The basic working principle of TMS is magnetic stimulation of key areas of the brain that are inactive in the patient by applying an electromagnetic coil over the scalp. Beforehand, some points on the head (nazion and right and left preauricular regions) are marked, and sound wave-emitting markers are fixed and the desired brain region is localized. TMS works very similar to the MR devices we normally use, creating magnetic field pulses of that power (1.5-2 Tesla).

TMS is an FDA-approved, safe, non-invasive treatment for depression and migraine. In addition to these, we perform TMS in our laboratory for research on its effectiveness in tinnitus (tinnitus), dementia, epilepsy, Parkinson’s and Alzheimer’s diseases.

Transcranial Magnetic Stimulation (TMS) in Migraine

It is a treatment method that migraine patients know more as TMS treatment and is frequently investigated for its effectiveness in migraine treatment. In migraine, TMS procedure is applied from the back of the head (occipital region). It can be done as a repetitive or single application. It is thought that magnetic stimulation also affects the release of some neurotransmitters by affecting electrical fields in the cerebral cortex. It can also affect the polarization of the nerve tissue in the area where it is applied. Data on its efficacy in the treatment of chronic migraine are not yet ‘sufficient’. However, it has been approved by the FDA (American Food and Drug Administration) for its use in the treatment of acute attack of migraine with aura.

What Kind of Treatment Method is Followed in the Neurology Clinic for Forgetfulness?

We plan the treatment after we determine the patient’s cognitive impairment, the form and characteristics of his forgetfulness, and make a diagnosis with known classical methods (BBT-MR, EEG, and Blood tests) and Neuropsychometric evaluations. Although the most classical treatment method is drug therapy, drugs are not effective for all conditions. Many supportive treatments are also needed. One of the basic approaches we take for this is Cognitive Rehabilitation. It is a method that can work in degenerative diseases, albeit progressive, such as Alzheimer’s disease.

Another treatment method is brain stimulation techniques, which we call non-invasive neuromodulation techniques (TMS), which have developed in recent years. TMS is a treatment method applied externally without any intervention to the brain and body. With this device, it is aimed to direct a high-powered magnetic field over the skull to the damaged areas of the brain to reactivate these areas that do not work well.

What Can Be Done to Cope With Neurological Diseases?

In order to make the diagnosis and treatment more effective in the field of neurological diseases, very promising results are obtained in ongoing studies all over the world. Many neurological diseases, which were considered incurable in the past, are in the group of treatable diseases. Technological developments accelerate the developments in the diagnosis and treatment of brain diseases, and the opportunities brought by the age are also applied to the diagnosis and treatment of neurological diseases. At Moodist Hospital, studies are carried out with great care to increase diagnosis and treatment opportunities for neurological diseases, and to make new arrangements for the care and rehabilitation of neurological patients.

Educating and informing our society about brain and nerve diseases is becoming increasingly important. Especially starting from schools, it is necessary to acquire the right eating habits that contain enough vegetables and fruits. In addition, informing about the prevention of smoking and alcohol use, providing environments to increase physical activity, regular control and appropriate treatment of hypertension, diabetes, heart diseases, strategies to prevent obesity should be considered as a whole not only with health centres but also with schools, parks, sports centres and public education strategies.

How Can I Help My Relative With Neurological Disease?

Considering the aging population, the rate of neurological diseases and emergencies is increasing day by day. Neurological emergencies are seen more frequently, especially in the elderly, compared to other emergencies. The importance of rapid diagnosis and treatment has increased due to the changing and developing treatment protocols recently. If not treated promptly, neurological emergencies are an important cause of death and disability in elderly patients. It requires additional attention and skill, as the diagnosis can sometimes be difficult and complicated in the elderly due to physiological changes and co-morbidities.

Among the symptoms of neurological diseases, symptoms such as headache, dizziness, loss of strength in the body, coordination problems such as inability to prevent movements, blurred consciousness, numbness or dizziness can be seen. For this reason, people who experience such symptoms should be examined by the nearest neurologist urgently