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How do neurologists diagnose brain and nerve conditions? Learn about the routine neurological exam, advanced imaging like MRI and CT scans, and what to expect during testing.
Send us all your questions or requests, and our expert team will assist you.
Diagnosing disorders of the nervous system is a complex detective process. Unlike a broken bone that is immediately visible on an X-ray, neurological conditions often involve invisible chemical imbalances or microscopic damage to nerve fibers.
Routine screening in neurology is different from other fields. While you might get a blood test for cholesterol annually, there is no single “routine” blood test for brain health. Instead, the Neurological Examination serves as the primary screening tool.
This is a non-invasive evaluation performed in the doctor’s office to check the function of the brain, spinal cord, and nerves.
The doctor evaluates your awareness and cognitive function.
12 pairs of nerves connect your brain directly to your face and neck. Testing them helps localize brainstem issues.
If the physical exam reveals an abnormality such as a weak left arm or hyperactive reflexes, the neurologist will likely order imaging to “see” the structure of the brain.
This is the most common and useful tool in neurology. It uses powerful magnets and radio waves to create detailed 3D images of soft tissues.
A CT scan takes a series of rapid X-rays to create a cross-sectional image.
Sometimes, pictures aren’t enough. Neurologists need to measure the electrical activity of the nervous system or analyze the fluid surrounding it.
The brain runs on electricity. An EEG records these electrical patterns (brain waves).
These tests check the health of the Peripheral Nervous System (the nerves in the arms and legs).
This procedure involves collecting Cerebrospinal Fluid (CSF), the clear liquid that cushions the brain and spinal cord.
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Preparation is vital for accurate results. Always follow your specific clinic’s instructions, but general guidelines include:
Neurological test results are rarely a simple “Yes” or “No.” They require expert interpretation.
A standard MRI means the structure of your brain looks healthy, with no tumors or strokes. However, you can still have a neurological condition with a normal MRI. Conditions like Migraine, Epilepsy, and Parkinson’s Disease often show normal brain structures in early stages. This is why the clinical exam and patient history are so important.
An abnormal result means the test found something unusual.
Neurologists use a combination of physical exams and technology to diagnose conditions. The most common tests include:
Preparation mainly involves safety regarding the powerful magnets used in the machine.
Food/Drink: You usually do not need to fast, unless your doctor is using a “contrast dye” to make the images clearer. In that case, you may need to stop eating 4 hours before the test.
Most neurological tests are painless.
Neurological tests are highly accurate for detecting structural problems. An MRI is exceptional at pinpointing tumors, strokes, or Multiple Sclerosis lesions with millimeter precision. However, tests can be “normal” even if you have a disease.
You typically need advanced imaging (like an MRI or CT) if your neurological physical exam shows abnormalities (like weakness on one side or abnormal reflexes), or if you have “red flag” symptoms.
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