Your Visit to the Neurologist

Going to visit a neurologist for the first time can be incredibly stressful. Being prepared can help reduce the stress. If there is paperwork to be completed, try hard to get it completed before the visit. This information is extremely helpful to your neurologist even though it may feel like you are repeating what has already been said and should be in your electronic medical record. Neurologists like to hear in your own words your history, so be prepared to tell a story about what has been going on with you that resulted in your visit. I always start a visit with a new patient with “Tell me what brings you here today” or “Tell me what I can do for you” or “Tell me about your symptoms.” Before I go into the visit with a patient, I have already reviewed their chart including reviewing any available scans like CT or MRI scans. But I want to hear the details in my patient’s own words.  It is helpful for you to have notes which may include a timeline of events. If you have written down notes that you are willing to share, bring a copy for your neurologist. Neurologists like a lot of details, so be prepared to answer questions after you have given your history.

Next, the neurologist will examine you. Neurologists gain a lot of information from the physical exam. The neurological exam guides a neurologist to which part of the nervous system is affected. This helps us arrive at a diagnosis or leads us to know what tests to order. We may examine you seated in your chair or on the exam table. Some neurologists will have you put on a gown. I usually do not. We often ask patients to take off their shoes and socks, so be prepared to show off your feet. Do not worry if your feet and toenails don’t look great though. We have seen a lot of feet! Your feet give us a window into your nervous system.

I usually don’t like to talk or answer questions while I am doing the exam because I am trying to focus on what I am doing and seeing. The exception to this is during the reflex exam when I often ask a question to distract the patient which helps to elicit the reflexes.

After the exam, I will ask the patient to return to their seat and put their shoes and socks back on. Do not worry if you have trouble getting on your shoes and socks. Neurologists are experts at this if you need help. I have become very adept at putting on socks and smoothing them out just right and getting shoelaces at just the right tension! I have also found that a tongue blade is a miraculous shoehorn!

Next will be the wrap up. If I can make a diagnosis at this stage, I will tell my patient the diagnosis and propose a treatment plan. If I am not certain of the diagnosis and need more testing, I will explain the tests needed and place the orders in the computer. At this time, you should be prepared to ask any questions that you have. Bring a list with you that you have prepared beforehand and be prepared to take notes with a pen and paper. If a patient does not have those handy, I will often write down a diagnosis if it is unusual or write down medication instructions. A plan will be made for follow up which often depends on the testing or treatment plan.