Neuro exam - help!

Hi,

I was wondering if some of you could answer a couple of questions that I couldn't find the answer to online.

I had a neurology exam today.

I had to stand with my eyes shut and put my hands out, I then had to touch my nose - I failed on 3 attempts and touched my mouth - could you possibly explain what this might mean?

I also failed to walk toe to heel in a straight line - I am recovering from a broken leg but felt it was more my balance - I couldn't manage more then 2 steps before wobbling off to the right.

The doctor also put pressure on various points on my face - some of which hurt a great deal and some of which I barely felt (points under my eyes and just in front of my ears hurt)

I'm not sure if it's related, but I had a big fall and pretty sure I hit my head (when I broke my leg)

My memory and coordination is so much worse recently.

I'd really appreciate your thoughts. I hope you can help me!

TIA

x

19 Replies

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  • Also, the doc wants to do a brain scan...

  • All of that sounds pretty normal for a first time Neuro examination. Dr is checking for your hand/eye coordination and the signals from the brain to those areas to see if it's functioning abnormally or correctly. I have those kind of test every single time I see my Neuro.

  • A brain MRI is the next step in your evaluation. It may or may not be with contrast dye which is injected into your arm between tests. Eventually doc may want to do a spinal tap to check the fluid. All pretty standard tests. I suggest you get yourself to a Neuro that specializes in MS and perhaps connected with a teaching University as they have the most up-to-date information tests etc.

  • Thanks for your input. I'd like to know what it meant when some of the points pushed on face hurt a great deal and some of which I barely felt (points under my eyes and just in front of my ears hurt)

    Any ideas?

  • Hi Polly, I have the same tests when I have my neuro exams, and it is very overwhelming in the beginning.

    Since you had a serious fall, I want to be sure that your neuro knows about the fall, so maybe you could have your primary care, and orthopedic guy, coordinate their notes with your neuro.

    When you have your scan, it will probably be a week or two before you have the results read with you.

    You really want to bring a notebook for that one.

    If you can think of any questions, jot them down, then you will remember them if they are already in your notebook.

    I would also, add a note in your notebook, to get a copy of the scan to take with you. If you do the scan in a hospital, you will want to tell them you want a cd rom copy of the scan.

    My first neuro was an awesome diagnostic neurologist, lovely woman, but she didnt truly understand MS, so if you can find a neurologist, that specializes in MS, you will have an easier time, because they can help you navigate the disease and disease modifying therapies etc.

    My current neurologist, has MS. He lives with MS, and knows exactly what it is like to live with this disease. He has a jam packed schedule, but always makes time for my questions.

    If you have time, attend an MS support group meeting in your local area. Ask the members who their neurologists are. You will definitely get feedback from the group members, and probably more advice than you ever thought possible.

    Neurologists, follow a protocol, so they have to do these tests, that seem odd in the beginning, but if you have a neurologist, that has the personality type qualities you like, you will be able to talk to them more easily.

    Please know that there are a lot of support out there, so be comforted and know that you will be ok. MS is a crazy ride, but your driving, so even though you dont have control of the disease, you can manage it.

    Let me know how your scan goes, and if you have an opportunity to attend an MS meeting, Im hoping all goes well for you.

    Be strong,

    Allie

  • Thank you that's really helpful. At the time, I completely forgot that I hit my head when I fell (and I haven't noticed any issues so didn't mention it to anyone in a professional medical context)

    I will email her and let her know. I can't believe I forgot about it.

    Thanks again.

  • Yes, it is good to keep your team informed. It helps your medical team to have all information. You will find that you have to manage your team, and make sure you have your lab results, scan results, appointment notes etc., are shared between practices. Thats why I always get a copy of my scans etc., just in case they forget to share results, you have it.

    No worries, we got your back :)

  • Hi Polly, glad to see you've received some pretty great answers and others comments. I think when they're pressing on various areas of your face they are checking to see how your nerves respond to those touches any of those areas are numb or if they have feelings as it all relates to what the nerve signals coming from your brain or whether their brain is miss firing those signals are doing just fine Did that make any sense? 😊 Please let us know how you were doing how your test results are and keep on coming back here and never hesitate to ask a question. There are a lot of really great people here and very helpful.

  • Pollyerrington Why didn't you ask the medico these questions at the time? I am continually amazed when people ask about these things here. The doctor is working for you. They are a service provider and you are the consumer. The same as taking your car to a mechanic. If the mechanic said they were doing some tests on your car would you not ask why and what the results were and what that meant for your car? If your doc won't tell you then you need to go to a different one.

  • shortyPPMS, I agree with you completely. Before I was diagnosed by a neurologist, my primary care physician examined me and told me I should see a neurologist. I asked why. She hesitated to tell me why. Finally she said she suspected I either had MS or brain cancer. Well I found out I wasn't going todie form brain cancer. :)

  • I was a bit emotional to be honest and she was a bit abrupt and it put me off asking. I wasn't expecting the tests and it just put me off.

    Maybe you could be a bit more understanding.

  • I wasn't intending to upset you but I have pointed this out numerous times here and else where. The days of the doctor being a god who can't be questioned are gone. I was just saying it is YOU they are talking about and everyone has the right to question anything they say or do and you need to or you will cause your self more stress worrying about what it might be about. It might be difficult if you are not used to questioning authority but they are not in a position of authority, they are working for you. My analogy with the car and the mechanic was to point out what the business relationship is with a medico. Remember, you are much more important than a car. Take care and keep smiling. Steve.

  • @Pollyerrington, the pinpricks at various spots on your face are done to find out if you've lost sensations in particular regions. Neurology has all of these areas mapped out, and they can tell what region of the brain is involved if you've lost sensation in one part of the face but not another part. I'm not sure how specific this is but they get a general idea that way.

    I can understand why you didn't ask your questions when you were with the doctor. I hesitate to take up too much of a doctor's time myself. My questions would probably seem silly and elementary, and I can try to find the answers in some way after I leave unless it's something really urgent.

    I let the doctors guide the discussion since that's the way most of them seem to like to do things. They have their schedule to keep to, and they know how much time they have for each patient. I don't like to say any more than I absolutely have to with a doctor.

    Once in a while I get a very chatty, friendly doctor, and I feel freer to ask questions, but most neuros I've dealt with haven't been especially chatty.

  • Thank you for helping. My doctor made me feel like I couldn't ask questions. And I was pretty emotional as it's the third slam to my health in the last 2 weeks.

    Thanks for your response, I really appreciate it.

  • Pollyerrington

    This is a typical neuro exam done every time I see my neuro and what I used to do whenever I saw a patient with a neuro problem: migraine, dizziness etc. looking for changes or deficits.

    He's checking for prprioception, balance sensation etc.

  • Pollyerrington, I understand not asking questions at the time of your exam. I tend to think of more questions after I leave. There can be so much information we are trying to absorb!

    I hope you have options in terms of neurologists and can perhaps search for one with better listening skills. Communication is very important in getting appropriate treatment for the MS and the its symptoms.

    I didn't see if you mentioned being diagnosed, but assume that has already happened.

    I agree that it's very helpful to write my questions down as I think of them, as well as keeping an ongoing list of symptoms, all of which I can give to my doctor.

  • Hi, I haven't been diagnosed with anything yet.

    I did read about babinski reflex and was sure in my exam my toes flared upwards. Just thinking about it makes them point upwards. So my boyfriend caught me by surprise and scratched up my plantar and my toes flared upwards according to him. So now I'm a little worried.

    Doc is U.K. so NHS - don't get much choice in who I see :(

  • G'day Tia, avoid lumbar Punctures, if ever suggested. Take 5mg Valium to stay still in the tube (MRI) Sounds like your Dr is closing in on ms as a diagnoses. These tests are pretty Standard neurological tests. Cool one is to close your eyes and lean left right back. Hand to nose tests are usually just co ordination. With ms I cant really do either, including balancing on one foot Hope u get your diagnose, and get on meds faster rather than slower.

    Royce

  • Thanks!

    She's sending me for a brain scan so will hopefully get a result. Thanks for MRI tip.

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