Neurologic consultation

What is a neurologist?

Neurologists are medical doctors who specialise in diagnosing, treating, and managing disorders of the nervous system—that is, the brain, spinal cord, peripheral nerves, and muscles. Their work combines clinical problem-solving with deep knowledge of neuroanatomy, physiology and neurologic disease.

What kinds of symptoms are referred to a Neurologist?

Neurologists are experts in investigation of a wide variety of symptoms. Common reasons for neurologic referral include:

Headache and facial pain
Seizures and blackouts
Weakness and motor problems
Sensory symptoms
Cognitive and behavioural changes
Visual, auditory or speech disturbances

Conditions We Commonly Manage Beyond Diagnosis

Beyond diagnosis, neurologists are also experts in the long term management of chronic neurologic conditions. Common examples include:

All of the Neurologists at Integrated Neurology have trained in Australian teaching hospitals and are accredited with the Royal Australasian College of Physicians and AHPRA.

What happens at a neurologic consultation?

A consultation with a neurologist is generally more extensive than a routine appointment with a GP and usually takes 45-60 minutes. The objective is to obtain a comprehensive account of the patient’s symptoms and to identify potential neurological causes and establish a plan for further medical investigations and treatment.

1. Detailed History-Taking

The neurologist will start by asking you lots of questions. These usually cover:

Symptoms: what you’ve experienced (e.g., headaches, weakness, numbness, memory changes), when they started, and what makes them better or worse.
Medical background: past illnesses, injuries, medications, family history of neurological disease.
Lifestyle factors: sleep, stress, alcohol, caffeine, and work patterns.

This history is often just as important as any test—here, neurologists are looking for patterns that might point to specific conditions.

2. Neurologic examination

A structured neurological examination follows. This is non-invasive and painless. Depending on the nature of the symptoms the neurologist may:

Assess higher functions: memory, concentration, language, and orientation.
Evaluate cranial nerves: vision, ocular movements, facial strength, hearing, and swallowing.
Test motor function: muscle strength, tone, reflexes, and coordination.
Examine sensation: light touch, vibration, temperature, and pain perception.
Observe gait and balance: the manner of walking, standing, and maintaining posture.

3. Clinical Impression

On the basis of the history and examination, the neurologist formulates an initial clinical impression, which may involve several possible diagnoses (a differential diagnosis).

4. Further Investigations

Where appropriate, additional tests may be requested, such as:

Neuroimaging (MRI or CT scans) to detect structural changes.
Electroencephalography (EEG) to measure brain electrical activity.
Electromyography and nerve conduction studies (EMG/NCS) to assess nerve and muscle function.
Blood tests and genetic testing when systemic or hereditary disorders are suspected.

5. Management Plan

Depending on the nature of the condition, it may be necessary to await results of further investigations prior to establishing a management plan. In other instances, a management plan may be established at the initial consultation. This may include:

The initiation or adjustment of pharmacological therapy.
Referral to allied health services (e.g., physiotherapy, speech therapy, occupational therapy).
Lifestyle recommendations tailored to the condition (such as sleep hygiene in the management of migraine).
Scheduling of follow-up appointments to monitor progression and treatment response.

Ultimately, the neurologist’s role extends beyond disease identification. The consultation seeks to understand the ways in which neurological symptoms affect the patient’s daily life and to establish a treatment strategy that addresses both medical and functional needs.