Neuroscience Department
Vithas’ Neuroscience Department is a multidisciplinary department where all medical specialists are involved in the diagnosis and treatment of patients with neurological problems, working in a coordinated manner with the aim of offering comprehensive medical and surgical care for neurological conditions at all stages of life.
Neuroscience is a very important area of clinical care due to the significance of neurological damage for the patient, their relatives and society. There are many neurological disorders and there are even more symptoms associated with them, so many patients consult on this topic.
Clinical diagnosis allows us to select patients with a truly neurological pathology and must be complemented by other examinations such as radiology or neurophysiology, for which having specialised neuroscientists is important. Due to the social impact of neurological conditions, centres that specialise in the field are highly regarded.
The Neuroscience Department is made up of multidisciplinary teams including neurosurgeons, neurophysiologists, neuropsychologists, neuroradiologists and rehabilitation specialists.
Technological equipment
In addition, both the facilities and technological equipment of Vithas allow the Neurosurgery Department to implement new, more complex techniques, such as skull base surgery, minimally invasive spine surgery, dementia diagnosis, hydrodynamic tests for hydrocephalus diagnosis and deep lesion biopsies.
The Neuroscience Department is equipped to perform innovative operations such as wide-awake surgery, making it possible to perform on eloquent areas, such as the language lobe, which are not yet performed in any private hospital in the region.
We have fully up-to-date equipment that allows patients to receive complete treatment, including a high-speed motor, state-of-the-art endoscope and a navigator for locating tumours without opening the skull.
The navigator recognises the patient’s face and fits the image obtained over that of a previous resonance. This makes it possible to guide an operation or locate a deep lesion. In superficial lesions, it allows incisions to be adjusted right where the tumour is, offering greater precision, greater safety and lower risk of complications.
Other techniques and treatments
- Intracranial pressure monitoring: Intracranial pressure monitoring is a direct diagnostic tool that records the patient’s intracranial pressure by means of a sensor placed on the head. It allows the diagnosis to be adjusted more accurately than with other indirect methods.
- Skull base surgery: Skull base surgery is performed in collaboration with otorhinolaryngologists and makes it possible to access the skull base through the nose using an endoscope, without the need for incisions.
This technique involves less complications, less time spent in hospital and more convenience for patients, who can be discharged after 3 days. - Minimally invasive spinal procedures: Minimally invasive spinal surgery through which fixations and screws are placed through small incisions in the skin.
Areas of specialisation
Neurology Unit (Adult and Paediatric)
The neurology unit treats patients with neurological conditions, such as cerebrovascular diseases, headaches, multiple sclerosis, epilepsy, neuromuscular diseases, Parkinson’s disease or dementias, performing a complete study, comprehensive treatment and follow-up on patients with nervous system disorders.
Within these illnesses, we treat those requiring urgent neurological attention, such as patients with strokes or epileptic seizures, among others.
Headache and migraine treatment
In the neurology unit we also treat conditions like headaches, which though common, can be disabling for many. After performing neuroimaging tests, we establish a medical regimen to improve the quality of life of patients who have headaches that interfere with their daily lives.
For patients with chronic migraines that are resistant to medical treatment, we perform a novel technique involving injecting botulinum toxin at the craniocervical level, which significantly decreases the frequency and intensity of headaches.
Other disorders treated in this unit are neurodegenerative diseases such as Parkinson’s disease, where we use all types of therapies for patients with both early-stage disease and more advanced stages.
Alzheimer’s and cognitive impairment
At Vithas we have all the resources needed to implement advanced therapies in patients who are progressing unfavourably with medical treatment.
We also treat patients with cognitive impairment associated with Alzheimer-type dementia, for which the neuropsychologists on our team perform a complete cognitive assessment.
Another novel diagnostic tool we offer for treating the disease is the determination of biomarkers of Alzheimer’s disease in the cerebrospinal fluid, which helps early diagnosis of the disease.
Neurosurgery Unit
The neurosurgery unit focuses on neurological diseases requiring surgical treatment. The most frequent conditions we treat are brain tumours and degenerative spinal conditions affecting the nerves, such as disc hernias.
Within urgent conditions, we treat brain haemorrhages, head injuries and spinal malformations.
Neurorehabilitation Unit
With 20 years’ experience, the aim of our unit is to meet the need for specialised neurorehabilitation in a comprehensive, personalised and multidisciplinary manner.
For this we combine professional care with the latest advances in the scientific and technical field, for both adults and children.
The most frequently treated conditions in our unit are:
- Cranio-encephalic injuries: traffic accidents, occupational accidents, assaults, etc.
- Strokes: cerebral infarctions and haemorrhages (aneurysms, vascular malformations, etc.)
- Cerebral anoxia: cardiorespiratory arrest, drowning, etc.
- Encephalitis and other infectious diseases of the central nervous system
- Tumours
- Neurodegenerative diseases: Multiple Sclerosis, Parkinson’s, etc.
- Spinal cord injuries
Neurophysiology Unit
The Clinical Neurophysiology Unit is concerned with the functional exploration of the central nervous system (brain and spinal cord), peripheral nervous system (nerves and sense organs) and vegetative or autonomic nervous system (sympathetic and parasympathetic), using highly specialised technology for diagnostic, prognostic and therapeutic orientation purposes.
It is a complementary exploration service to support diagnosis and follow-up for various specialities such as Traumatology, Rehabilitation, Rheumatology, Neurology, Paediatric Medicine, Ophthalmology, Otorhinolaryngology, Neurosurgery, Psychiatry, Pulmonology, etc.
Cognitive Impairment Unit
Vithas’ Cognitive Impairment Unit is a consultation-investigation-diagnosis service in which an initial, comprehensive assessment of the patient’s symptoms (Alzheimer’s, frontotemporal degeneration, vascular cognitive impairment, Dementia with Lewy bodies, adult-onset chronic hydrocephalus, etc.) is carried out on the same day, through all the studies needed to achieve a definitive, concrete and quality diagnosis:
- General analytics
- Neuroimaging (magnetic resonance imaging preferably)
- Cognitive, socio-family, functional and behavioural assessment
- Final neurological assessment with report addressed to the referral professional and/or patients/relatives
Our team of professionals is composed of neurologists, nurse neuropsychologists and radiologists who work synchronously during the patient’s day at the cognitive impairment unit, following a clear guideline: that a rapid, quality diagnostic process is key for the proper management of patients and relatives with this type of impairment.
Sleep Unit
Vithas’ Sleep Unit focuses on addressing patients' sleep disturbances.
It consists of the Sleep Disorders Clinic, the Sleep Laboratory and the Interconsultation with various related medical specialities.
Sleep disturbances
Its aim is to assess and treat people with various symptoms of sleep disturbances:
- Persistent feeling of lack of or poor-quality sleep
- Feeling insufficiently rested when getting up in the morning
- Drowsiness throughout the day
- Sleeping during the day, without being able to help it
- Intense snoring
- Breathing disturbances during sleep (pauses)
- Restless sleep, with lots of tossing and turning
- Talking, shouting, sleepwalking.
- Behaving strangely during sleep
What sleep disorders do we treat?
There is now evidence that a high percentage of the general population suffers from some type of sleep disorder. Schematically, the most relevant are:
- Insomnia
- Restless legs syndrome
- Narcolepsy
- Idiopathic hypersomnia
- Apnea-hypopnea obstructive sleep syndrome
- Behavioural disorders (parasomnias): somnambulism, night terrors, confusional arousal, nightmares, REM sleep behaviour disorder
- Circadian rhythm disorders:
- Shift work disorder
- Delayed sleep phase syndrome
What is the role of the Sleep Disorders Clinic?
Unlike monographic sleep disorder clinics, which do not look at the entire pathology and where patients are studied from a partial vision of sleep disorders, without looking at all the possible disorders the same patient may have.
The sleep unit clinic has the following advantages:
- Addresses all types of sleep disorders.
- Coordinates the interconsultation with the different related medical specialities.
- Demands objective tests after a differential clinical diagnosis, filtering indiscriminate and unfounded requests for them.
- Encourages the use of scales and questionnaires for subjective assessment of sleep disorders.
- Optimises the therapeutic resources of the various sleep disorders by adapting them from a global perspective for each patient, who may often have more than one disorder and require multifactorial treatment.
- Information to patients and family members about their sleep disorders.
What diagnostic tests are performed?
In addition to the clinic, the Sleep Unit has a sleep laboratory with the technical resources and staff needed to perform the diagnostic tests required for each case:
- Complete and monitored nocturnal polysomnography.
This technique analyses the different phases and cycles of sleep (sleep architecture) as well as the various associated clinical abnormalities: respiratory alterations (apneas), abnormal movements, abnormal behaviour, abnormal brain bioelectrical activity. It is a bloodless test, without punctures or incisions, that uses electrodes and sensors that are applied to the surface of the skin. Patients can move freely in bed while the test is being conducted.
- Multiple sleep latency test.
The multiple sleep latency test (MSLT) is a polysomnographic technique that is performed during the day to check for abnormal daytime sleepiness. It is helpful to diagnose narcolepsy.
- Maintenance of wakefulness test.
The maintenance of wakefulness test a technique similar to the one above that measures “resistance” to falling asleep involuntarily during the day.
- Suggested immobilisation test.
The suggested immobilisation test is used to detect periodic limb movements, characteristic of restless legs syndrome.
- Actimetry.
Actimetry is a method used to measure sleep/activity cycles. It is useful to asses insomnia and changes in the circadian sleep/wake rhythm.
Video-Electroencephalography Unit (VIDEO-EGG)
Video-EEG monitoring involves simultaneously recording the patient’s clinical symptoms (video) and electroencephalographic activity (EEG) over a variable period of time depending on the indication used.
It is used in the objective functional diagnosis of brain bioelectrical activity in various neurological diseases, and is particularly relevant for the assessment of epileptic patients.
The unit has specific staff, both doctors and nurses, with extensive experience and training to conduct the procedure, from applying the recording techniques to assessing the results.
- The nursing staffplace the electrodes and sensors on the patient, save the useful data and are in charge of the technical control of the recording to optimise its quality and filter out artifacts, in addition to controlling the focus of the video camera from the computer.
- The medical staff are responsible for the proper running of the unit, reviewing the recordings obtained and compiling the reports.
Routine video-EEG is used in brain bioelectrical exploration applied in the diagnosis of various neurological conditions, both structural disorders (brain tumours, cerebral vascular accidents) and metabolic disorders (encephalopathies, infections, comas, brain death), and of course in epilepsy.
Prolonged video-EEG monitoring is primarily used to assess epileptic patients. Its indications are:
- Performing differential diagnoses between epileptic and non-epileptic seizures.
- Detection, characterisation and quantification of seizures in cases where the type of seizure or epilepsy is not clear. In addition to an assessment of the patient’s triggers.
- Documentation of the circadian pattern of seizures (onset time) and the influence of drugs on changes in the seizure patterns.
- Documentation during epileptiform pattern sleep and its impact on sleep architecture in so-called cognitive epilepsies (paediatric medicine).
- Monitoring in intensive care units (status epilepticus, abnormal movements in comas).
- Pre-operative assessment for epilepsy surgery candidates.
Range of services
- Routine Video-EEG.
- Video-EEG after partial sleep deprivation (prolonged recordings of 1–2 hours), with the patient previously subjected to partial sleep deprivation to trigger epileptiform brain bioelectrical abnormalities.
- Prolonged video-EEG, of various lengths: up to five hours, between 5 and 10 hours, 24 hours.
- Video-EEG lasting more than one day: diagnostic and evolutionary assessment of patients with treatment-resistant epilepsy.