Neurologist vs neurosurgeon — what's the difference?

A neurologist is a physician: they diagnose and treat diseases of the brain, spinal cord and nerves using medication, lifestyle interventions and rehabilitation. Epilepsy, migraine, multiple sclerosis, Parkinson's disease, stroke prevention and peripheral neuropathies are largely their world.

A neurosurgeon is a surgeon: we treat conditions where an operation is either the definitive treatment or one of the main options. Brain and spinal tumours, aneurysms, disc herniations, hydrocephalus and traumatic bleeds are largely ours.

In practice we overlap constantly. A patient with new seizures might see a neurologist first for anti-epileptic medication, and then be referred to me if a tumour or vascular lesion is found on MRI. A patient with severe sciatica might see me first, and then be referred to a neurologist if the imaging is unremarkable but their symptoms suggest a neuropathy.

If you are not sure which one to see, start with your GP. They can look at your symptoms and point you to the right specialist. Sending you to the wrong one first wastes time and money.