Neurology

Neurology is the specialized branch of medicine that studies the pathologies of the central nervous system (brain, cerebellum, brainstem and spinal cord), of the peripheral somatic system (spinal roots and ganglia, nerve plexuses and trunks) and of the peripheral autonomic nervous system (sympathetic and parasympathetic ganglia, extravisceral and intravisceral plexuses).

Neurological knowledge relies heavily on discoveries made in the field of neuroscience, the body of scientifically conducted studies of the nervous system.

Neurological diseases

Neurological diseases are the responsibility of neurology for their study and diagnosis. Neurology is interested in these diseases on the basis of the site of injury to the brain and assumes that neurological diseases are closely related to the site of injury.

In other words, this means that lesions at different sites of the brain, produce different symptoms – even if the lesions were caused by the same disease or cause and that different neurological diseases, if they affect the same region of the nervous system, may produce similar or identical symptoms and signs to each other.

Assuming this, one must keep in mind, therefore, that in the field of neurology one cannot consider a neurological disease unless it is closely related to the anatomo-functional site of the nervous system in which it occurs.

Diagnostic procedure

The first phase of the diagnosis is the reconstruction of the patient’s clinical history, the recording of the symptoms that manifest the disorder, their mode of onset and evolution.

It is therefore necessary to consider

  • a temporal parameter: when did the disorder arise? what caused it?
  • an evolutionary parameter: how did it worsen over time and with what intensity?
  • a parameter of aggregation of symptoms: which symptoms have been aggregated over time to the pre-existing ones?

The diagnosis must involve not only the patient, but also the informants, i.e. the relatives, and the patients must also be considered on the basis of their current or previous therapies, considering how any drugs (although not necessarily psychotropic) may affect the functioning of the central nervous system.

The global diagnosis combines the cognitive-behavioral history with the objective neurological examination, the revelation of signs of a possible lesion of the central nervous system, aimed at investigating the integrity of functional systems (for example, motor or sensory).

Only through this integration will it be possible to allow the formulation of localizing hypotheses (where the lesion is located in the brain) and diagnostic hypotheses (what is the disease or cause that caused the disorder).

Finally, instrumental diagnostic investigations aimed at confirming or disconfirming the diagnostic hypotheses to be verified can be selected from this point.

Classification of neurological pathologies

As with other medical pathologies, neurological pathologies are classified according to the pathogenetic mechanism.

They should therefore be distinguished:

  • Cerebrovascular diseases;
  • Infectious and inflammatory diseases;
  • Neoplastic diseases;
  • Degenerative diseases;
  • Traumatic diseases.

A separate consideration, however, deserves epilepsy.

Related keywords

  • Neurologist

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