When to See a Neurologist: 10 Symptoms You Should Not Ignore

A neurologist is a physician who specializes in diagnosing and treating disorders of the brain, spinal cord, nerves and muscles. Many people are referred by their primary care doctor, but it is not always obvious which symptoms call for a specialist. Some neurological symptoms are mild and temporary; others are early signs of a condition that is easier to treat when caught early. And a few require immediate emergency care.

Here are ten symptoms that are worth discussing with a neurologist, along with practical advice on preparing for your first appointment.

First: Symptoms That Need 911, Not an Appointment

Call 911 immediately for sudden facial drooping, arm or leg weakness, trouble speaking, loss of vision, loss of balance, a sudden "worst headache of your life," a seizure lasting more than five minutes, or confusion with fever and a stiff neck. These may be signs of a stroke, bleeding in the brain or a serious infection, and treatment is time-sensitive. Learn the BE FAST stroke warning signs.

10 Symptoms Worth a Neurological Evaluation

1. Frequent or changing headaches

Most headaches are not dangerous, but headaches that occur often, are getting worse, wake you from sleep, change in pattern or require pain relievers several days a week deserve an evaluation. Frequent migraine can often be prevented with the right treatment, including Botox for chronic migraine in eligible patients.

2. Numbness, tingling or burning

Persistent pins and needles in the hands or feet, numbness in particular fingers or burning foot pain may indicate peripheral neuropathy, carpal tunnel syndrome or a pinched nerve. Nerve testing can pinpoint the problem.

3. Weakness

Dropping things, tripping over a foot, difficulty climbing stairs or rising from a chair can come from nerves, muscles or the brain. Weakness that develops quickly is urgent.

4. Dizziness and balance problems

Recurrent spinning, unsteadiness or falls have many causes, from inner ear problems to neuropathy. A neurologist can separate harmless causes from serious ones. See our guide to vertigo and dizziness.

5. Memory loss or confusion

Forgetfulness that is new, progressive or noticed by family members should be evaluated. Some causes are reversible, and early diagnosis helps with planning and treatment. Read about the early signs of dementia.

6. Seizures or unexplained spells

Staring spells, episodes of lost time, sudden jerks, unusual sensations or any convulsion should be evaluated, usually with an EEG.

7. Tremor or slowness of movement

Shaking hands, smaller handwriting, stiffness or a shuffling walk can be signs of essential tremor, Parkinson's disease or medication side effects.

8. Involuntary muscle movements

Neck pulling, eyelid spasms, facial twitching or muscle cramps during specific tasks may indicate dystonia or another movement disorder, many of which respond to targeted treatment.

9. Vision changes

Double vision, temporary loss of vision in one eye or blurred vision with eye pain can have neurological causes, including TIA and multiple sclerosis. Temporary vision loss in one eye needs prompt attention.

10. Back or neck pain that travels

Pain radiating down an arm or leg, especially with numbness or weakness, can indicate nerve root compression. Loss of bladder or bowel control with back pain is an emergency.

What a Neurologist Does at Your First Visit

The neurological evaluation is detailed but not invasive. Your neurologist will ask about your symptoms, medical history, medications and family history, then perform a neurological examination that checks mental status, cranial nerves (vision, eye movements, facial strength, hearing and swallowing), strength, reflexes, sensation, coordination and walking. Based on the findings, your doctor may recommend tests such as:

• EMG and nerve conduction studies for nerve and muscle problems.
• EEG for seizures and spells.
• Carotid and transcranial ultrasound for stroke risk.
• Computerized cognitive testing for memory and thinking.
• Blood tests, MRI or CT scans.

Neurologist or Neurosurgeon?

People sometimes wonder whether they need a neurologist or a neurosurgeon. A neurologist diagnoses and treats nervous system conditions with examination, testing, medication, injections and other non-surgical therapies. A neurosurgeon performs operations on the brain, spine and nerves. Most neurological symptoms, including headaches, numbness, seizures, memory changes, tremor and dizziness, are best evaluated by a neurologist first. If testing shows a problem that may need surgery, such as severe nerve compression or a structural lesion, your neurologist can help coordinate a surgical opinion while continuing to manage your overall neurological care.

How to Prepare for Your Appointment

• Write down your symptoms: when they started, how often they happen, how long they last and what makes them better or worse.
• Bring a medication list, including vitamins and over-the-counter products.
• Bring prior results, such as MRI or CT reports and recent blood work, and the referral if your insurance requires one.
• Record episodes on your phone if they come and go, such as tremor, spells or abnormal movements.
• Bring a family member if memory or spells are a concern, since they may have noticed details you have not.
• Complete new-patient forms in advance when they are available online to save time at check-in.

Questions to Ask Your Neurologist

• What do you think is causing my symptoms, and what else could it be?
• Which tests do I need, and what will they show?
• What are my treatment options, and what are their side effects?
• What warning signs should prompt me to call or seek emergency care?
• When should I follow up?

See a Neurologist in Westwood, NJ

Our private neurology practice on Kinderkamack Road in Westwood has served patients in Bergen County for many years. Our physicians diagnose and treat epilepsy, stroke, Alzheimer's disease, headaches, Parkinson's disease, peripheral neuropathy, multiple sclerosis, vertigo, neck and back pain and other neurological disorders, with many tests available in our office. Our staff is fluent in Spanish and Tagalog, and the practice participates in most health insurance plans.

Download our new-patient forms and find directions on the contact page, or explore our neurology services.

This article is for general education and does not replace advice from your own physician. If you think you are having a medical emergency, call 911.