What is neurology?

Neurology i the branch of medicine, which deals with the treatment and study of different disorders related to the nervous system. The human nervous system is a sophisticated and complex system that coordinates and regulates body activities. The nervous system has two main divisions as the central and peripheral nervous systems. A physician with having specialization in neurology is termed a neurologist.

Neurologists deal with the disorders of the nervous system and brain as:

• Cerebrovascular diseases and accidents (stroke)
• Multiple sclerosis (demyelinating diseases)
• Headaches
• Infections of the peripheral nervous system and brain
• Other degenerative diseases as Parkinson’s disease and Alzheimer’s disease
• Epilepsy and other spinal cord disorders
Neurologists aren’t professionals for performing surgeries, but they refer their patients to neurosurgeons for the surgeries.

Neurological examination:

The neurological examination consists of history taking, subjective/objective examination, and different tests to check for diseases and disorders. Neurologists play their role as primary health care providers or consultants. Any patient suffering from neurological disorders requires more frequent care and observation in comparison to other patients.
Patients with typical disorders as Alzheimer’s disorders, Parkinson’s disease, and Multiple sclerosis require extra care and observation. For instance, in cases of specific neurological conditions such as headaches, concussions, and stroke, neurologists will consult to recommend the appropriate surgical treatments.

Neurology and psychological traumas:

Other than neurodegenerative disease, neurology also includes other psychological diseases/illnesses and traumas as well. Psychological traumas and PTSD (Posttraumatic stress disorder) are the most common disorders related to the neurology field. Most of the time, trauma survivors or patients complain of being misunderstood by others.
Traumatized patients are always advised to move on and forget what happened in their past. However, these patients can never forget their worst experiences, but they have to live with them for the rest of their lives with even worst pain.
Several interventions and treatments are helpful for patients suffering from psychological traumas. However, there are only a few treatments that have evidence-based effectiveness for the problems.

Neurological therapies for trauma patients:

Exposure therapy and CBT (Cognitive Behavior Therapy) are the most common and widely used traumatic interventions. CBT treatment focuses more on the prevention of initial trauma response to prevent the development of PTSD (Bisson, Ehlers, Matthews, Pilling, Richards, & Turner,2007; Kornor, Winje, Ekeberg, Weisaeth, Kirkehei, Johansen, & Steiro, 2002). CBT helps in addressing the distortions of emotions and beliefs to enhance personal wellbeing and safety. Moreover, this therapy also helps decrease feelings of helplessness and hopelessness to replace the feelings and beliefs of negative perceptions.

On the other hand, exposure therapy is an effective treatment technique for patients to recover from trauma-related distress (Jaeger, Echiverri, Zoeller, Post & Feeny, 2009). The therapeutic approach in exposure therapy includes a gradual confrontation with the trauma or trauma-related info either through journaling or talking. Avoiding to talk or discuss the trauma can deceive patients that they have forgotten their bad memories, but in reality, it only intensifies the remains of the trauma in the brain. A confrontation with the trauma can help with facing the fear by provoking the memories of that event. This approach decreases the evident symptoms of the trauma and other feelings as heightened arousal and avoidance of facing them. When the patient confronts the memories from the same experience, he loses the power to generate the same intensity of fear and hurt as they were in the original event. A frequent and repeated session of fear confrontation can ultimately eradicate the problem itself (Holmes, Arntz, & Smucker, 2007).

Neurologists always suggest a combination of relaxation and exposure therapy. The relaxation exercises and therapies help the patients avoid being re-traumatized by the emotions and information they encounter from the exposure therapy. Imagery rescripting in the form of exposure therapy deals with showing threatening or confronting images to patients and then replacing them with positive ones. Imagery rescripting therapies can help in developing new perspectives and positive emotions. There are several pieces of evidence the exposure therapy or imagery to change the responses of anger, shame, and guilt for patients suffering from PTSD related to childhood and sexual abuse (Smucker, Dancu, Foa, & Niederee, 1995).
Narrative therapy also combines with CBT or exposure therapy to help the patients in reconceptualizing their bad event (Augusta-Scott & Dankwort, 2002). Narrative therapy is based on the approach to change the patient’s perception because the behaviours and emotions of patients depend upon their perceptions. In this approach, patients are emphasized or encouraged to talk about their bad experiences to their therapist narratively. Patients are always given enough flexibility to narrate their stories either by having precise or detailed conservation. After developing different narratives about specific conditions, patients can realize their power to counter the negativity and develop a more positive attitude. Narrative therapy has enough evidence of treatment for the patients or survivors of torture, childhood abuse, rape, war, and mass violence (Robjant & Fazel, 2010).
Other meditation techniques such as MBSR (mindfulness-based stress reduction) and EMDR (eye movement desensitization and reprocessing) are also used. These meditative techniques encourage the increased capacity for focusing attention and reduce the fear arousal in the patients (Cochran, Pruitt, Fukuda, Zoellner, & Feeny, 2007). As a result of these techniques, patients feel more aware of their environment and perceptions. Focusing on the sensory experiences can help the patients require the necessary cognitive focus, which helps broaden the perspectives and reduce reactive responses (Tarrier, Liversidge, & Gregg, 2006).
Stress inoculation therapy is another type of treatment (Ponnian & Hollon, 2009) for traumatized patients which involves three main steps:
• A conceptualization phase to provide information about the specific trauma and establish goals
• Rehearsal phase to practice the cognitive and behavioural coping strategies within a safe environment
• Implementation phase to apply all of these strategies in the real-time experience of a patient’s life
A combination of CBT, exposure therapy, and stress inoculation therapy can help in reducing the symptoms of trauma in the patients (Johnson, Bradley, Furrow, Lee, & Palmer, 2005). Utilizing emotions therapy involves coping strategies such as learning skills, positive self-talk, self-compassion, and relaxation, which can help manage different overwhelming and negative emotions. Along with these non-invasive or non-medicated therapies, drug therapies also come under the field of neurology. Drug therapy is also helpful in PTSD treatment. The most frequent medications are anti-depressants, paroxetine, and other SSRIs (selective serotonin reuptake inhibitors).
Takeaway:

Neurology is a holistic field to deal with the physical and psychological traumas in an individual. Neurologists are experienced professionals who deal with medications and therapies for neurological/psychological problems. Surgery doesn’t come under the field of neurology, but neurosurgery deals with the surgeries.

References:
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