Neurology and Neurorehabilitation – the difference in expert opinion
29 June 2017
Many solicitors tell NRC Medical Experts that they are confused about the expertise they are relying upon, particularly when asking for opinions from neurologists and neurological rehabilitation physicians. Understanding the difference between these two specialist areas is important when considering instructing an expert witness.
What does a neurological rehabilitation expert do?
Neurological rehabilitation physicians specialise in the management of disabling conditions arising from disorders of the nervous system.
Neurological rehabilitation experts specialise in determining the functional consequences of neurological conditions – a way of describing what someone is able to do now, (such as walking, talking or cooking for themselves) and what they are likely to be able to do in future as their condition progresses.
This includes the management and subsequent avoidance of complications of these neurological conditions which will impact on function – including someone’s pain, mood, anxiety, muscle contracture and spasticity.
Neurological rehabilitation physicians manage disabling conditions such as acquired brain injury long-term, observing how a person’s condition develops. This means they are ideally placed to comment on someone’s condition and prognosis. Neurological rehabilitation specialists are expert at working in multidisciplinary teams alongside colleagues from therapy, nursing, neuropsychology, clinical psychology, care, augmented communication, orthotics and vocational rehabilitation. They spend most of their time looking after people with acquired brain injury, spinal cord injury, peripheral nerve injury (brachial plexus and Guillaine-Barre Syndrome) as well as chronic conditions like multiple sclerosis, and also functional conditions.
Therefore, neurological rehabilitation experts see how these conditions affect people in the broadest sense in their community and how a wide range of professional interventions can optimise a person’s function and quality of life. A medical expert witness qualified in neurological rehabilitation is best placed to report on and explain the impact of these issues..
What does a neurologist do?
In contrast, Neurologists are specialists in the primary diagnosis and treatment of disorders of the nervous system. They are expert in the investigation of symptoms and signs and the interpretation of scans and tests such as MRI, CT and nerve conduction studies. Neurologists focus primarily on the acute management of conditions in the short-term – they rarely see the long-term outcomes and do not assess a person’s function.
Neurologists spend most of their time investigating and treating headache, epilepsy, multiple sclerosis, Parkinson’s Disease, intracranial pathology such as brain tumours, and also excluding hard pathologies to reveal functional conditions. A neurologist’s expertise does not therefore relate fundamentally to establishing a person’s condition and prognosis.
Seeking the right expert opinion
In answering the questions relating to condition and prognosis posed by solicitors, it’s important to consider how often a report from a neurologist defers to the expertise of a neurological rehabilitation physician.
In major personal injury or clinical negligence cases relating to acquired brain injury, it is more financially economical and a quicker option to instruct neurological rehabilitation physician in the first instance. This means solicitors can rely on the expertise of the neurological rehabilitation expert witness to involve neurologists where necessary.
As the UK’s only expert witness chambers specialising in neurorehabilitation, we are best placed to provide the right medical expert witness for your case.