Introduction
Functional neurology and medical neurology are two different approaches to maintaining the body’s neurological function. The following article discusses the significant differences between the two and where they can be applied.
The brain works through many complex pathways and controls every body function. Apart from controlling all the body’s metabolic processes, many emotions are also influenced by the brain. Whenever the working of the neurons is compromised microscopically, the brain health suffers. Therefore, the person can present with mood disorders, migraines, or even irritability. This is where functional neurology comes into play. However, any gross changes in the brain which require medications and surgery are dealt with under medical neurology. [1]
A person suffering from migraines can have normal MRI scans. Still, through functional neurology, specific exercises can help alleviate its symptoms. On the other hand, a person who has undergone brain ischemia needs immediate intervention by a neurologist, so that extent of paralysis of the limbs can be decreased or reversed.
Functional neurology uses non-invasive procedures to restore the function of underworking neurons. The techniques are applied to specific areas of the brain to decrease the effects of the disease but not completely cure it.
How do the two work?
Functional neurology can be applied to many neurological disorders. However, they mainly deal with patients with concussions (post-brain injury), movement disorders, degenerative disorders, vestibular disorders, and also mood disorders such as depression or PTSD. Functional neurology believes that such brain lesions exist due to some deficiency; this can be nutritional deficiency, functional deficiency, or hypoxia. All can result in neurons that do not work at their full potential. Therefore, the brain’s visceral, sensory, and cognitive functions are impaired.
Functional neurologists do not claim to treat the patient entirely but offer to decrease the progression of the disease and help restore the neurons’ function if they cannot transfer electrical signals properly. A mixture of rehabilitation therapy, chiropractic sessions, and recommended lifestyle modification. [2]
On the other hand, medical neurology deals with all kinds of brain disorders and prescribes medications for them. It works by suppressing or expressing specific receptors that help treat the pathology. Furthermore, surgical interventions are also applied when needed.
How does the examination of the two differ?
Functional neurology works by examining the specific area of the brain causing nervous system disorders. After a thorough examination, the location, type, and severity of neuronal imbalance are assessed. However, a medical neurologist also performs examinations to determine the site of the lesion and treats it through medication, which can impact the whole central nervous system.
The examinations done by functional neurologists are as follows;
- Eye movements
- Activation of the vestibular system
- Sensorimotor stimulation
- Balance therapy
- Exercises
Functional neurologists focus on applying physical non-invasive stimuli to help restore the function of neurons. It is best used on patients that suffer from the following set of neuronal disorders;
- Vertigo or dizziness
- Tremors of limbs
- Post-concussion symptoms
- Mild trauma to the brain
- Neuropathy of the peripheral nerves
- Alleviating the effects of chronic migraines and headaches [3]
Medical neurology has a very different approach; it starts with a complete history of the symptom and an examination of the central nervous system. This examination helps fixate on the lesion. Specific investigations are then advised to narrow down the cause. After that, pharmacological agents are prescribed to help treat the issue. CNS examination includes seven main components to assess the following components;
- Mental status
- Cranial nerves
- Motor system
- Reflexes
- Sensory system
- Coordination of movement
- Assessment of gait [4]
It is hard for medical neurologists to form a diagnosis for many neurological disorders in which patients complain of poorly characterized symptoms. For instance, a person with multiple sclerosis needs to have 90% damaged neurons to show a positive scan to get treatment for the disease. Therefore, functional neurology can be used to help improve the quality of life of that individual through various non-invasive techniques. Therefore, functional neurology can be used for initial management of neurological disorders by using a holistic approach towards such disorders, improving the quality of life of that individual. However, medical neurology is then applied to help treat and cure the disease which improves the morbidity and prognosis of the patient.
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