Neurologist vs. Neurosurgeon – Who Should You See?

When it comes to brain, spine, and nervous system issues, most people don’t realise two different types of specialists may be involved in their care: neurologists and neurosurgeons. While both play crucial roles in diagnosing and treating neurological conditions, their expertise, training, and day-to-day responsibilities are quite different.

In this blog, we break down the key differences between a neurologist and a neurosurgeon, helping you understand who to consult for what condition. Whether you're dealing with migraines, epilepsy, spine problems, or brain tumours, this guide will help you make the right choice.

What is a Neurologist?

A neurologist is a medical doctor who specialises in diagnosing and treating disorders of the nervous system, which includes the brain, spinal cord, and peripheral nerves. Neurologists do not perform surgery; instead, they focus on managing neurological conditions through medications, therapy, and non-invasive procedures.

Training and Education

• Medical school (MBBS or equivalent)
• Residency in Neurology (typically 3 years)
• Optional fellowship in sub-specialties like stroke, epilepsy, movement disorders, etc.

What Does a Neurologist Treat?

• Migraine and other headaches
• Stroke and TIAs
• Epilepsy and seizures
• Parkinson’s disease
• Multiple sclerosis
• Dementia and Alzheimer’s
• Neuropathy and nerve pain
• Vertigo and balance disorders
• Myasthenia gravis
• Sleep disorders

Diagnostic Tools Used by Neurologists

• MRI or CT scans
• EEG
• EMG/NCS
• Lumbar puncture
• Blood/genetic testing

What is a Neurosurgeon?

A neurosurgeon is a medical doctor trained to perform surgical procedures on the brain, spinal cord, and peripheral nerves. While they are also trained in diagnosis and management, their main focus is surgical intervention.

Training and Education

• Medical school (MBBS or equivalent)
• Residency in Neurosurgery (6–8 years)
• Fellowship in areas like brain tumour surgery, spine surgery, or vascular neurosurgery

What Does a Neurosurgeon Treat?

• Brain and spinal cord tumours
• Traumatic brain injuries
• Spinal disc herniation and fractures
• Aneurysms and AVMs
• Hydrocephalus
• Chiari malformation
• Epilepsy surgery
• Peripheral nerve entrapment
• Deep brain stimulation for Parkinson’s

Neurologist vs. Neurosurgeon: Side-by-Side Comparison

While both specialists deal with neurological conditions, here’s when to consult each:

When Should You See a Neurologist?

• Frequent headaches or migraines
• Persistent dizziness or vertigo
• Seizures or blackouts
• Memory loss or confusion
• Numbness or tingling
• Chronic nerve pain
• Muscle weakness
• Sudden visual or speech issues

When Should You See a Neurosurgeon?

• Brain or spinal tumours
• Herniated disc or spinal compression
• Brain aneurysm or AVM
• Refractory epilepsy
• Head/spine trauma
• Hydrocephalus or Chiari malformation

How They Work Together

Neurologists and neurosurgeons often collaborate. For example:

• A neurologist may manage seizures but refer the patient to a neurosurgeon if surgery is needed.
• A neurosurgeon may remove a brain tumour after a neurologist diagnoses it via symptoms and imaging.

Sub-Specialisation

Neurologist Sub-specialties:

• Epileptologist
• Neuroimmunologist
• Stroke specialist
• Headache specialist
• Neurogeneticist

Neurosurgeon Sub-specialties:

• Spine surgeon
• Neuro-oncologist
• Vascular neurosurgeon
• Paediatric neurosurgeon
• Functional neurosurgeon

Salary and Lifestyle

Neurosurgeons typically earn more due to the complexity of their work. However:

• Neurologists have more predictable schedules and less emergency involvement.
• Neurosurgeons face longer hours and emergency surgeries, especially for trauma or critical cases.

Choosing the Right Specialist

If your symptoms seem medical (e.g., headache, seizures, dizziness), start with a neurologist. If you've already been diagnosed with something structural or surgical (e.g., tumour, disc herniation), see a neurosurgeon. General physicians can help direct you to the correct specialist as needed.

Conclusion: Understanding the Difference Matters

Understanding the distinction between neurologists and neurosurgeons is vital when facing any neurological condition. While neurologists manage conditions medically, neurosurgeons focus on surgical correction. Both specialists are crucial, and in many cases, they work together to ensure the best possible patient outcomes.

If you are unsure whom to consult, begin with a neurologist—like Dr. Amit Aiwale at Solaris Hospital, Thane—who can evaluate your condition and refer you to a neurosurgeon if needed.