Neurology in Metro Manila

Neurology is a branch of medicine that focuses on the diagnosis and the treatment of diseases of the nervous system. The nervous system is a complex and sophisticated system that regulates and coordinates our body activities. It is divided into two major parts:

• The central nervous system: the brain and spinal cord
• The peripheral nervous system: all nerves branching out from the brain and spinal cord, and extend to other parts of the body, including organs and muscles.

Since the nervous system is complex, there are numerous subspecialties within the field of neurology, including:

• Neurodevelopmental disabilities
• Pediatric or child neurology
• Neuromuscular medicine
• Pain medicine
• Hospice and palliative care neurology
• Headache medicine
• Vascular Neurology (stroke care)
• Sleep medicine
• Autonomic disorders
• Brain injury medicine
• Neuropsychiatry
• Epilepsy
• Neurointensive care

A doctor who specializes in treating diseases of the nervous system is called a neurologist. Symptoms that often require a neurologist help may include coordination problems, muscle weakness, confusion, dizziness, and a change in sensation. People who are having problems with their senses, such as vision, touch, or smell, may also require to see a neurologist since problems with senses are sometimes caused by disorders of the nervous system.

A neurologist may also treat patients with:

• Stroke
• Seizure disorders, such as epilepsy
• Migraines and headaches
• Brain aneurysms
• Brain tumors
• Peripheral neuropathy
• Multiple sclerosis
• Infections of the nervous systems, such as meningitis, encephalitis, or brain abscesses
• Neuromuscular disorders, such as myasthenia gravis
• Neurodegenerative disorders, such as Alzheimer’s disease and Lou Gehrig’s disease
• Sleep disorders
• Spinal cord disorders, such as autoimmune and inflammatory disorders
• Speech and language disorders

Keep in mind that neurologist does not perform surgery. If you need surgery, you will be referred to a neurosurgeon.

What does Neurology Involve?

A wide variety of different tests and procedures are used to diagnose and treat neurological conditions. On your first appointment with a neurologist, a physical and neurological exam is likely to be performed. A neurological exam is done to test muscle strength, coordination, and reflexes.

Because different diseases can have similar symptoms, more than one testing may be required for your neurologist to make a diagnosis.

Some of the procedures that fall into the field of neurology may include:

Electromyography

Electromyography (EMG) is used to measure how well your muscles react to electrical stimulation from motor neurons, which are specific nerves controlling muscle movement. It can help neurologists diagnose general muscle or nerve dysfunction, as well as spinal cord disease.

During an EMG, small needles called electrodes are inserted into the muscle by a specially trained technician. The electrodes can measure the different electrical activity occurring in muscle tissue during periods of movement and rest.

Electroencephalogram

Electroencephalogram (EEG) is performed to assess and record electrical activity in your brain. Neurons in our brain communicate with other neurons through electrical impulses, which an EEG can record. Brain wave patterns can also be tracked by an EEG. It is used to help diagnose conditions of the brain, including tumors, inflammation, injuries, as well as psychiatric disorders, epilepsy, and seizures.

During an EEG, electrodes are placed on your head. The electrodes are connected to a computer, which converts electrical signals into patterns that can be seen from a screen or printed on a piece of paper.

Lumbar puncture

Lumbar puncture is done to test your spinal fluid. It involves inserting a needle into your spine after numbing it with an anesthetic. Using the needle, a sample of your spinal fluid is taken.

A lumbar puncture can help diagnose the following conditions:

• Meningitis
• Encephalitis
• Leukemia
• Myelitis
• Dementia
• Autoimmune diseases, such as multiple sclerosis (MS)
• Bleeding in the brain

The procedure can also be used to treat conditions affecting the spinal cord. Your neurologist may inject anesthetics, cancer treatments, or antibiotics using a lumbar puncture needle.

Tensilon test

To help diagnose myasthenia gravis, your neurologist may perform a tensilon test. It involves the injection of a medicine called Tensilon. Then, your neurologist observes how medicine affects your muscle movements.

Sleep study

Chronic sleep problems are diagnosed in a Sleep Study. Also known as a Polysomnogram (PSG), this procedure involves monitoring patients during sleep and physiological data is recorded electronically.

Other tests

Other types of tests may be used by your neurologist to make a diagnosis. These may include:

• Magnetic resonance imaging (MRI scan)
• Computed tomography (CT scan)
• Positron emission tomography (PET scan)
• Biopsy
• Genetic testing
• Angiography

Botox injections

Botox injections can be done to treat some neurological conditions, such as cerebral palsy, that can cause your limbs to pull in toward your center. Sometimes, these contracted muscles can be relaxed with Botox injections.

Botox injections involve injecting tiny amounts of botulinum toxin into your skin of muscles using a thin needle.

Brain tumor treatment

A range of treatments can be done to treat a brain tumor. If your neurologist believes that you need surgery, you will be referred to a neurosurgeon who will remove as much of the brain tumor as possible through surgery.

A brain tumor may also be treated with radiation therapy, which uses high-energy beams to kill tumor cells.

Brain tumor treatment may be integrated between the departments of neurology and oncology.

Brain rehabilitation therapy

Brain rehabilitation therapy is used to help you relearn functions that are lost as a result of a brain injury. Brain rehabilitation therapy is usually integrated between specialty teams in the departments of neurology, sports medicine, psychiatry and psychology, neuroradiology, and the vestibular/balance laboratory.

Deep brain stimulation

During deep brain stimulation, electrodes are implanted within certain areas of the brain. The electrodes generate electrical impulses that can regulate abnormal impulses. These electrical impulses may also affect certain chemicals and cells within the brain.

Deep brain stimulation can be done to treat numerous conditions, including dystonia, essential tremor, epilepsy, and Parkinson’s disease. It is also being studied as a potential treatment for multiple sclerosis and stroke recovery.

Spinal stenosis treatment

Spinal stenosis is a condition that occurs when the spinal canal narrows and pinches the nerves, leading to back and leg pain. Spinal stenosis may be treated with pain medications, physical therapy, steroid injections, decompression procedure, or surgery. Surgery is usually performed if other treatments have not helped.

How Long Should I Stay in Metro Manila?

Your length of stay depends on the type of procedure you have, you may be allowed to leave the hospital on the same day or you will stay for several days. For diagnostic procedures, you should be allowed to leave the hospital on the same day. However, you should wait until the results of the test are ready before you can fly home, which may take as long as 7 days, sometimes even longer. If you undergo brain tumor treatments or other types of treatment, especially treatments that involve surgical intervention, you should aim to stay in Metro Manila at least for 10 days.

What's the Recovery Time?

The recovery time can be different for each procedure. It may also depend on the reason why you are having the procedure and your overall health. Your neurologist and neurosurgeon will give you a recovery timeline for each procedure. The recovery period for diagnostic procedures is typically short and you may be able to resume your normal activities within a week or so. For surgical procedures, you may need to wait 4 weeks or months until you can go back to your daily routine, including work and exercise.

What About Aftercare?

A detailed aftercare instruction will be given to you following your procedure. While the instructions will be different for each procedure, they typically include a diet plan, exercise, restrictions, and wound care (if any surgical intervention is involved). You should follow these instructions carefully in order to have a speedy and smooth recovery.

You may also need to attend follow-up checkups to monitor your overall condition and healing. For brain tumors, you may need to attend regular checkups to ensure the tumor has not come back.

What's the Success Rate?

The field of neurology is constantly advancing. The success rate of each procedure is typically high, particularly when performed by highly skilled and experienced medical professionals. Still, some procedures may carry some risks, such as bleeding, infection, and nerve injury.

Are there Alternatives to Neurology?

Since neurology is the branch of medicine to diagnose and treat problems of the nervous system, there are no other alternatives. However, if your doctor found that your disease or illness is found to be caused by other problems unrelated to the nervous system, your doctor will recommend you to see the relevant doctor.

Neurology in and around Metro Manila

About Manila

Manila is the capital of the Philippines and is divided into 16 districts; it is one of the densest and populated cities of the world. Each district has its own history and cultural legacy. The city was under the rule of Spanish conquerors for almost three centuries. You can see the remains of that era in the ruins of the historical buildings. Today, the City is very modern with tall skyscrapers and modern architecture.

The Philippines is developing into one of the top countries in the world for medical tourism. Approximately 15 million people globally travel to other countries in search of quality medical care at affordable prices. Manila is a favorite destination due to the following reasons:

• It provides state-of-the-art procedures at affordable prices.
• With excellent infrastructure, the City can handle the large numbers of foreigners who visit Manila.
• The Hospital and clinic staff are very competent, friendly, and educated and have a good knowledge of English to communicate with their patients.  
• The doctors are very well-qualified and hold international certifications.
• The city has a reputation in providing excellent post-surgical care by the nurses and physiotherapists.
• The Medical Industry provides many alternative therapies at some of the best spa resorts. You can combine a surgical procedure with alternative healing therapies at the same time.

Popular Areas in Manila

Manila Bay has many tourist spots and you will find many monuments that depict the Spanish occupation of the country. There are many Baroque Colonial Churches that will enable you to appreciate the artistic designs.

The National Museum of the Philippines, Bahay Chinoy, the National Art Gallery, and the Metropolitan Museum of Manila are some of the popular museums that you must visit in Manila. Rizal Park also known as Luneta is a historical urban park that is worth visiting.

There are also many organized tours that can help you get the best out of your sightseeing, for example, the Intramuros Tour, Rizal Park Tour, or the Skyscraper Gazing Tour and more.

Manila is a very modern contemporary city as the historical buildings have been replaced by modern architecture with better planning and layout and the buildings are earthquake resistant.

The city has many cultural and religious festivals throughout the year. There are plenty of shops, both big and small where you can buy branded goods at affordable prices.

Weather and Climate in Manila

The Philippines is a tropical country and in Manila, you will not experience too much temperature variations. January is the coolest month while May is the warmest month. The average temperature remains between 14°C and 38°C. The rainy season is between May and November. The rest of the months are dry. Manila is a humid city and bad weather such as Typhoons may occur during the months of June and September.

Getting around in Manila

People traveling from nearby countries such as Malaysia and Indonesia can use the City’s sea entry points. For all other passengers, the best option is to take the air route.

The Ninoy Aquino International Airport is the City’s major international airport. It has four different terminals that connect via bus transfers. If you are taking a connecting flight, remember to keep some time as a buffer, as transfers may force you to travel through the busy streets of Manila. Terminal 1 caters to International flights and Philippine Airlines uses T2 and domestic carriers and international carriers use T3 with budget carriers largely using T4.

You can take a bus from the airport to the city. Taxis have meters and you can hail a cab outside the airport. Buses and small vans or jeepneys are popular modes of transport within the city.

Manila has three light rail systems and one heavy train line. The light rail systems are the LRT-1, LRT-2, and MRT-3. You can also use the pedicabs and tricycles for shorter distances. In some areas, you can even find horse-driven carriages called calesa.

Tourist Visas in Manila

The visa process is not a very complex system as the Philippines has a visa waiver program for certain countries. All European nations, South American countries, and many others form part of this program. Citizens from these countries can stay in Manila for up to 30 days, whereas nationals from Brazil and Israel may stay in Manila for 59 days. Hong Kong, Macau, and Portugal residents can stay for 14 days without a visa. Tourists belonging to other countries need to apply for a visa to enter the Philippines, in the consulate in their respective countries.

You must also have a valid return ticket. Passport must also be valid for at least six months and beyond to stay in the country. Visa-exempt people may extend their stay by one or two months after which they will have to apply for a visa.

Additional Information

• The currency of the Philippines is Peso (symbol: ₱). It is strong in the world market and the usual exchange rate is 1 Dollar equals 50 Pesos. Dollars are easy to exchange compared to other currencies.
• Credit cards are acceptable in almost every place. The city also has many ATMs from where you can withdraw money without difficulty. However, ATMs will charge you a minimal exchange fee on foreign cards.
• Bargaining and negotiating are acceptable in most places and it can get you better deals.
• Restaurants may add a service charge of up to 10%. You can pay a cash tip of 5 to 10 %. People often round off the taxi fare.
• Manila is a city full of people who speak English proficiently. Filipino and English are the two official languages. Filipino is a variety of Tagalog, Austronesian languages.
• Hindu, Muslim, Buddhism, and Christian religions have left their mark on the Philippines at different periods. Today, a majority of the population is Roman Catholic.
• There are many public holidays in Manila. Some of the important ones are Christmas Eve, Christmas, Eid al-Fitr (Ramadan), Labor Day, New Year, and Good Friday, etc. The Independence Day falls on June 12th and Manila Day on 24th June.