Back from neuro

[Dagny]

I'm just back from my neuro and not sure what to think. The good news is that the exam was all normal. However, he sent me for an EMG and an MRI scan. I was hoping that he would say that since the neurological exam is ok, then there is no need. It was very hard to get anything out of him and when I asked about MS, he said that the only sure way of ruling it out is to do the MRI, which I already know but was hoping for more info based on my symptoms. He also said that some of my symptoms, like pins and needles in arms and legs would be compatible with MS but he wouldn't think it's high risk. I didn't find it reassuring and got a bit freaked out. He also did all sort of blood tests, for coeliac, vit d, CK and syphillis! The last one really shocked me and no idea why he would do it! Would've asked him but it was all in acronyms and only googled at home.

I won't see him for 4 weeks, so won't know the results till then. Do you think I should be concerned or is just routine standard practice with neuros?

[Yuliasir]

I'd say it is rather standard procedure becasue the only way to eliminate MS correctly at now is via MRI, so if you need to be cleared out of MS, the only way is to get MRI. Many of our fellows have undergo it. EMG is standard procedure to exclude fine changes in the neuroconduction which could not be still seen on clinical exam. This is pretty standard for ALS/MS rule out (I had EMG for example).
Some doctors do not prescribe that, some do - it depends on certain procedures or protocols accepted by doctor or by medical institution.

Syphilis is of course rare now, but it is still possible to get it even not via sexual contact but via public swimming pools etc. In fact it is a neurodegenerative disorder on later stages and it can cause pins and needles in the limbs. It is strange but such syphilis could run almost asymptomatic until the final issues would be obvious. Considering that your djctor desires to exclude all and any possibilities, no wonder he prescribed MRI/EMG too.

I would say please do not worry, your doctor acts in a pretty standard way on my point of view.

[Dagny]

Thanks so much Yuliasir, you are very good to reply so promptly and your answers are always very informative!

Also wanted to ask you, as you appear to have some knowledge of it, would the visual symptoms of MS be quite obvious? I think I'm just paranoid but have been experiencing a bit like glare at the bottom corner of one of my eyes. It's very hard to describe, a bit as if I could see my lower lashes. It's quite subtle but worries me a bit.

[Yuliasir]

I know by blogs at least two people whos MS had started from optical neuritis. In both cases it was severe disturbance of central vision like - oh i can see well in the center but can not see on the outer edge of vision field COMPLETELY lik it doest not exist, or in another case it was vice wersa loss of central fiels while on the edge everything was Ok. In both cases it was quite painful also. In no case it was not sublte. and it was not transient, I mean it lasted for days.

we can have subtle temporary blurring caused by liquid emerged from our tear glands and we can have optical mirgraines (auras) looking like lucid semitransparent zigzagous obkect moving across th vision field (holy crap, it is VERY SCARY, i was VERY MUCH scared when it had happened to me once), and finally the whole vision site becomes blurry like watered TV screen - but that is harmless. So if you would had something like that, do not worry. A glare in the lower part of the eye might be casued exactly by some light scattering on the lashes (maybe you have lower lid a bit swollen, ehich happens sometimes, so they moved a bit higher. I would not worry anyway becasue it is a subtle one. MS symptomes are strange. celar, like a boiling water, and not subtle, think about that. they definitely make people stop and say hey what the hell is going on (migraine causes the same, but it lasts 10-30 minutes, not hours and days).

[aztwitchy]

I'm just back from my neuro and not sure what to think. The good news is that the exam was all normal. However, he sent me for an EMG and an MRI scan. I was hoping that he would say that since the neurological exam is ok, then there is no need. It was very hard to get anything out of him and when I asked about MS, he said that the only sure way of ruling it out is to do the MRI, which I already know but was hoping for more info based on my symptoms. He also said that some of my symptoms, like pins and needles in arms and legs would be compatible with MS but he wouldn't think it's high risk. I didn't find it reassuring and got a bit freaked out. He also did all sort of blood tests, for coeliac, vit d, CK and syphillis! The last one really shocked me and no idea why he would do it! Would've asked him but it was all in acronyms and only googled at home.

I won't see him for 4 weeks, so won't know the results till then. Do you think I should be concerned or is just routine standard practice with neuros?

routine practice...they are doing their due diligence to check everything they can think of. I had all the same tests done. My guess is you will come back clean on everything. Maybe low vitamin D since a large % of us are.

[KateBN]

I went through the same experience recentlh and had the same reaction. I have primarily tingling with some twitches. The exam was good, but I had the MRI and EMG to confirm it's nothing more. MRI was pristine. EMG was clean. Nerve conduction study less so, but an appointment with a specialist ruled out anything serious. I think the MRI and EMG are fairly standard practice.