Neurologist in Latviawhere to get treatment, how to verify certification, what this doctor does

A neurologist diagnoses and treats disease of the nervous system: the brain, spinal cord, peripheral nerves and muscles.

• Stroke and its consequences
• Epilepsy and seizures
• Headache and migraine
• Multiple sclerosis and other demyelinating disease
• Parkinson's disease and other movement disorders
• Alzheimer's disease and other cognitive disorders
• Spine and disc problems, radiculopathy
• Tick-borne encephalitis and other nervous system infections

A family doctor is enough for occasional headaches that respond well to treatment. A neurologist is needed when symptoms recur, progress, or new neurological problems appear.

The Centre for Disease Prevention and Control, working with the Latvian Neurology Society and the Latvian Stroke Society, has produced a digital stroke recognition test, available at atpazistiinsultu.lv.

Stroke signs, which appear suddenly:

• Paralysis, numbness or weakness on one side of the body
• Difficulty speaking or understanding speech
• Visual disturbance
• Dizziness, loss of balance and coordination

A stroke is sudden damage to the brain. More often it results from a blocked vessel, called an ischaemic stroke, and less often from a ruptured vessel, called a haemorrhagic stroke. The most common causes of ischaemic stroke are atherosclerosis in the brain or neck arteries and atrial fibrillation; for haemorrhagic stroke, high blood pressure or an aneurysm.

The Centre for Disease Prevention and Control states that Latvia is among the leading countries in Europe for stroke incidence per 100,000 population. It also notes that in recent years patients have been reaching stroke units with the diagnosis made early, and that more than 60 per cent of patients leave the stroke unit without significant signs of disability.

• Six years of medical study and a doctor's degree, at RSU or the University of Latvia.
• Residency in neurology. Programme page: RSU residency programme.
• The certificate is valid for 5 years. Recertification requires 250 continuing education points, at least 60 per cent tied to the base specialty, plus a 48.38 EUR fee.
• Entry in the practitioners register must be renewed every 5 years.

• Area of disease. Neurology is broad, and doctors often focus on epilepsy, movement disorders, multiple sclerosis or headache. Ask when booking.
• Tests on site. If Doppler ultrasound, EEG or MRI is likely, a provider that performs them saves appointments.
• Level of seniority. Some price lists separate out senior neurologist consultations, which cost more.
• Paperwork. If you need a referral to VDEĀVK, ask whether the doctor issues it and what it costs.
• Second opinion. Patients may freely choose the doctor and institution.

• The visit begins with questions about the symptoms, their character, location, onset, possible causes and course, plus past illnesses.
• The neurological examination tests cranial nerve function, including eye movements, approximate visual fields, facial sensation, and the muscles of facial expression and the tongue.
• General functions are also checked: blood pressure, pulse, leg swelling and the state of the veins.
• Bring earlier investigations, including CT and MRI images and reports, plus a full list of medicines.
• If symptoms are episodic, a diary of how often and how long they last and what triggers them is useful.

In the public system, with a referral, a specialist visit costs 4.00 EUR. Private prices vary by the doctor's seniority and whether procedures are performed during the visit.

• Senior neurologist, first consultationPrice EUR: 75.00Provider: Veselības centrs 4
• Senior neurologist, repeat consultationPrice EUR: 65.00Provider: Veselības centrs 4
• Neurology consultation to complete a VDEĀVK referralPrice EUR: 50.00Provider: Veselības centrs 4
• Repeat neurology consultation alongside proceduresPrice EUR: 25.00Provider: Veselības centrs 4
• Patient co-payment for a specialist visitPrice EUR: 4.00Provider: NVD

Several organisations represent the field:

• Latvijas Neirologu biedrība, registration number 40008017147, contact Evija Miglāne, neirologi.lv.
• Latvijas Insulta biedrība, registration number 40008219296, contact Evija Miglāne.
• Latvijas Bērnu neirologu biedrība, registration number 40008037675, contact Mikus Dīriks, bernuneirologi.lv.
• Latvijas Neiroimunologu asociācija, registration number 40008197726, neuroimmunology.lv.

Certificates are issued by the Certification Council of the Latvian Medical Association. The sector regulator is the Health Inspectorate.

If you have doubts about the quality of care, raise them first with the provider's management. If that does not resolve it, a written submission goes to the Health Inspectorate no later than two years after the alleged infringement, and is reviewed within 30 days, extendable to four months in complex cases. The procedure is set out on the Health Inspectorate site.