Neurologists and neurosurgeons are both specialists in treating the brain and nervous system.

The main difference is that a neurologist is a physician, while a neurosurgeon performs surgery, explains Dr Olusola Adedipe, a neurosurgeon and specialist spine surgeon at Mediclinic Highveld.

Should I see a neurologist or a neurosurgeon?

If you’re experiencing unexplained symptoms that require a brain and nervous system specialist to be involved, a neurologist would probably be your first port of call. They can diagnose conditions and prescribe non-surgical treatments, such as medication or lifestyle interventions. However, if surgery is necessary, you will be referred to a neurosurgeon.

What conditions does a neurosurgeon treat?

“The list of conditions treated by a neurosurgeon is inexhaustive,” says Dr Adedipe. However, they can be categorised into:

  • Congenital conditions (conditions a person is born with), such as hydrocephalus (abnormal accumulation of cerebrospinal fluid in the cavities of the brain ); Chiari malformations structural defects in the skull, where brain tissue extends into the spinal canal); intracranial haemorrhages (brain bleeds); and spinal conditions like spina bifida (when the spinal column doesn’t fully close during development in the womb).
  • Neoplastic conditions (abnormal growths), such as tumours on the brain, spinal cord, pituitary gland, nerve sheath and spine.
  • Vascular conditions (to do with your blood vessels), such as vascular malformations, aneurysms (abnormal bulge in a blood vessel); Moya Moya disease (narrowing of arteries in the brain); fistulas; and strokes
  • Nervous system injuries, such as head injuries due to gunshot, motor vehicle accidents, and assaults, as well as different haematomas.
  • Functional conditions, such as epilepsy, dystonia (involuntary contraction of muscles); Parkinson’s disease; pain management; and headaches.
  • Degenerative conditions, such as spinal degenerative diseases and peripheral nerve diseases.
  • Central nervous system infections, such as meningitis; encephalitis; brain abscesses; epidural abscess; and subdural empyema (abscess in subdural space).

A neurologist will also treat many of these conditions but unlike neurosurgeons they will not perform surgery. They will also treat conditions such as concussion, and dementias like Alzheimer’s disease.

When to get help

“A patient is advised to see a neurosurgeon if they have symptoms attributable to a nervous system problem,” says Dr Adedipe. However, because the brain and nervous system are involved in every part of the body’s function, signs can show up in all kinds of ways and some may be unexpected. “Patients with sudden hand tremors, and urinary and faecal incontinence should be advised to see a neurosurgeon without delay,” he cautions.

Other signs that may indicate that you need a neurosurgeon:

  • Sudden coma
  • Obtundation (being sleepy all the time and slow to respond)
  • Speech disturbance
  • Epileptic seizures 

It’s also important not to ignore any other signs that may not seem as obviously serious. Dr Adedipe recommends seeing your healthcare professional if you experience:

  • Headaches
  • Nausea
  • Vomiting
  • Gait imbalance (unsteadiness on your feet)
  • Blurred vision
  • Memory, cognitive, and intellectual deterioration (you can’t think or remember as well as usual)
  • Neck pain
  • Arm numbness, tingling or weakness
  • Bladder and/or bowel sphincter dysfunction.

If you’re unsure of your symptoms and what they may be related to, see your GP who will be able to refer you to the correct specialist. Most importantly, never ignore unexplained symptoms.

Visit to find a Neurologist or a Neurosurgeon at a Mediclinic near you.