First visit to a neurologist for B12 deficiency

[olicana1949]

I was diagnosed with B12 deficiency Oct 2020, had loading injections, as orally supplements had on effect, which cured some symptoms, but not all. Been referred to a private neurologist this Saturday. What should I expect and what should I be asking?

[fbirder]

The neurologist should do lots of physical tests - checking for feeling in your extremities, reflexes, muscle strength, balance. They may get a nerve conduction test done, where they stick thin wires into your limbs and pass a small electric current (it zaps a bit, but isn't really painful).

They should get a lot of bloods taken, looking for anything that may cause your neuropathy. From the description in your earlier posts it doesn't sound like a typical neuropathy caused by a B12 deficiency.

They will ask a lot of questions about your past health and your lifestyle.

By the end of the session they should be able to give you a good idea as to what is causing your neuropathy. Ask them what you can do to cure it, if anything. How long before things should get better. What the prognosis is.

[olicana1949 in reply to fbirder]

Many thanks for this specific information and all the other posts that are really helpful

[Sleepybunny]

Hi,

1) You could ask the neurologist to check your proprioception sense (position sense).

In short ,this is awareness of where your body is in space.

B12 deficiency can lead to problems with proprioception sense.

For example, my balance used to deteriorate if it was dark, my eyes were closed or someone walked directly towards me and blocked my view of my surroundings.

Two tests that can help check proprioception sense are

1) Romberg test

2) Walking heel to toe with eyes closed

These tests should only be carried out by a doctor at medical premises due to risk of loss of balance

Videos of these tests on Youtube.

If neurologist does not do any tests with patients eyes closed then it's unlikely that proprioception sense has been fully tested.

Link about proprioception

sciencedirect.com/topics/ne...

Be well prepared for appointment.... I hope your neurologist is kind and understands B12 deficiency...not all of them do.

2) You could ask neurologist what level of treatment patients with B12 deficiency with neuro symptoms should receive.

If you're in UK, have a copy of the BNF info below with you in case your neurologist is not well informed.

BNF Hydroxycobalamin

bnf.nice.org.uk/drug/hydrox...

Good luck

[Cherylclaire Forum Support]

I saw a neurologist and he also ordered an MRI scan on my brain , which is useful if you have cognitive/memory issues - certainly put my mind at rest to know that brain was found to be "normal for my age". If physical tests reveal balance, numbness etc. , a scan of spine might be done too.

[Nackapan]

I didnt get any tests? Then on the thitd one he did check reflexes

So do ask

I expect the testing depends on your symptoms.

Mine were balance and head pain mainly.

Mri's can be ordered too.