I was reading a post on an MS forum the other day - unfortunately I can't find it now - but it was a neurologist explaining what they were looking for and what the tests meant when people with MS or suspected MS went for an examination.
An interesting feature of the examination described was that all the tests undertaken were those with 'eyes open.' Not once did the neurologist suggest that the people with suspected MS have the same tests done with 'eyes closed.'
I'm no neurologist, but I do realise that the standard practice appears to be that many tests are undertaken to establish if the patient has motor damage (a feature of MS) with eyes open, but then tests aren't done with eyes closed to establish if patients have proprioception issues (a feature of b12 deficiency).
From the MS patients point of view it was quite interesting. Some people were 'failing' to get MS diagnosed because they completed the motor tests. Yet they weren't given the same tests to establish if there were proprioception problems (which may indicate damage resulting from a b12 deficiency).
From the perspective of b12 patients, if you get a neurological exam, you MUST make sure the neuro does both kinds of tests because in many cases they will do the motor tests as a norm, and if you pass, they will not complete with proprioception tests.
Going through my records I can give perfectly good examples here:
I have had 3 neuro exams.
In two it was found that I had poor heel/toe walking, left sided balance problems, and failed Rhombergs (amongst other things)
In one it said I had good heel/toe walking, no left sided balance problems, and passed Rhombergs.
Now, how confusing is that?
Not confusing at all really if you understand that in the first 2 exams I passed all the tests with my eyes open, but failed them with my eyes closed.
In the third exam, I only had tests done with my eyes open. Of course I was going to pass - I always do.
(Mind you, no one has ever tested my hopping which I can't do with eyes open or closed!)
So, the first two indicate I have damage to my spinal cord, the third indicates there are no spinal cord problems. But only because the neuro didn't do the correct tests!!!!
Remember - test with eyes open and closed.