Neurologist

A physician who specializes in treating diseases and disorders associated with the nervous system that includes spinal cord, brain, associated nerves and muscles. To be a neurologist, one should have completed four years of graduation, four years of medical school, one year of internship in internal medicine/surgery and three years of neurology residency. They can further hold a sub-specialization in stroke, epilepsy etc. They should also be certified by a recognized board.

A neurologist conducts

• Neurological assessment of the nerves related with the neck and head.
  
• Checks on movement of the muscles and the strength of the same.
  
• Checks on ambulation, balance and reflexes.
  
• Checks for sensation, speech, language, memory, and various other cognitive skills.
  
• They ask for diagnostic tests in few patients such as CAT scan, MRI, EEG, EMG/NCV and lumbar puncture and analyze those results in relation to the disorder of the patient.
  

• With latest CAT scans understanding the diseases have become a lot easier.
  
• MRI (magnetic resonance imaging)/MRA (magnetic resonance Angiography) gives a better understanding of the structures.
  
• NCV (nerve conduction velocity) give a better understanding of the nerves.
  

Pervasive Development Disorder

The term Pervasive Development Disorders (PDDs) is an umbrella term used to refer to a group of developmental disorders of the brain function. These cover the whole family of autistic spectrum including Asperger syndrome, Heeler's syndrome and Rett disorder. As PDD covers such a wide spectrum, it is exhibited differently from child to child. Children with these disorders are often confused in their thinking and they have problems understanding the world around them. Since these conditions are identified in children around 3 years of age, which is a critical period in the child's development, they are called development disorders. Even if the condition begins earlier than 3 years of age, parents often do not notice the problem until the child is a toddler who is not walking, talking or developing as well as other kids of the same age.

Diagnosis of Pervasive Development Disorder

Much of the diagnosis depends on the accurate developmental history and evaluation of the current functioning of the child. Complete medical history and physical exam is done for a complete evaluation by doctors. Although there are no laboratory diagnosis in PDD, various blood tests and X rays are done to determine if there is a physical disorder causing these symptoms. In the absence of any physical disorder, the child is referred to a specialist in childhood development disorders such as psychiatrist or psychologist, pediatric neurologist or other professionals trained to treat PDDs. Inputs from the parents of the affected child, his/her teachers, and other adults who are familiar to the child are sought. Parents require ongoing counseling and support and they must understand that they are not responsible for the child's condition.

Neuro Ophthalmologist

All vision problems need not necessarily stem from the eye. Some vision problems involve the brain. Neuro ophthalmology is the sub specialty of both neurology and ophthalmology. A neuro ophthalmologist is a Physician who specializes in the diseases affecting vision that originates from the nervous system. Conditions such as optic nerve disorders, loss of vision from central nervous system disease, double vision diplopia and involuntary movement of the eyes nystagmus are some of the disorders under the purview of a neuro ophthalmologist. An ophthalmologist attends to patients with disease or injury in the eye ball, cornea and the lens or into the eyeball at the retina inside the eye. If any problem occurs behind the eye in the optic nerve or in some distinct visual pathways connecting the brain, it requires the special skills of a neuro ophthalmologist.

A neuro ophthalmologist could be an ophthalmologist or a neurologist with additional special training. After completing a residency program in any one of the two specialty areas, they take a fellowship in neuro ophthalmology for a year or two before starting to practice as a neuro ophthalmologist. A neuro ophthalmologist attends to a full spectrum of neuro ophthalmic conditions including evaluation, diagnostic and referral services of rare and complex disorders. A neuro ophthalmologist caters to:

• Patients who suddenly lose part of their side vision.
  
• Patients suffering from double vision.
  
• Patients with unequal pupils.
  
• A patient suffering form a stroke.
  
• A patient with brain tumor
  
• Patients who suddenly have their vision out of focus
  
• Any and every patient with unusual vision problems.

In addition to the above, a neuro ophthalmologist provides emergency evaluation of a wide variety of disease that can cause visual loss. Unexplained visual loss can arise out of uncommon disease conditions like myasthenia gravis, multiple sclerosis, mitochondrial disease and other muscular diseases that affect the eye. The neuro ophthalmologist uses special testing techniques including visual fields, visual evoked response, imaging studies such as CT, MRI and Angiography and ultrasound to diagnose the disease patterns. It becomes necessary for the neuro ophthalmologist to work closely with other medical specialists to offer multidisciplinary care and solution for complex cases.