Unclean Clinical Exam

[misterjuanperalta]

Seizures are in my family. A past eeg showed epileptiform activity, plus some current symptoms.

[RobJ]

It all depends how you act in front of the neuro. If you are positive, no weakness, they are more apt to state it's benign. If you go in distraught, down and out, discussing all your issues, negative, they are more apt to run a battery of tests.

I've been in your shoes in a hospital bed in Boston. I had every single test under the sun because at the time, I was very ill. The illness brought out the fascics. The young doctors were extremely amused with the twitching and my elevated CPK. They were on a mission to find out why. This was many moons ago.

How was your demeanor when you visited the neuro?

Remember, no weakness means no MND or MD. Forget everything else. I won't say good luck because you don't need it. You need a more experienced doctor.

[misterjuanperalta]

I had a list of many symptoms, a mirror and his findings. I spoke with him about my belief I have ***. I showed him the areas of concern, after which the clinical exam kicked in. I failed based on the two clinical findings above. I mentioned BFS, and he did not acknowledge it.

[Neville86]

Juan:

Let me remind you of this little thing you said to joycecarroll a few weeks ago: "No weakness, No ALS"

[jwb33w]

Twitches and brisk reflexes was the neuros criteria for a failed clinical? Or the dystrophy? Cuz if it's the former than I suppose all on this board would fail the test

[misterjuanperalta]

I know, but my throat, swallowing has been scary. My legs hurt a lot. Eventhough., no weakness, no als.

[Neville86]

Agree with jwb. 80 percent would fail based on your neuros criteria. Did he say to you tht "you failed" and he suspects ALS or is this your interpretation?

[Neville86]

But again: what were te words your neuro said? I don't care what anxiety is saying to you/making you feel (well, I do, but you know what I mean)

[misterjuanperalta]

Neuro said findings make him suspect ALS, jump starting tests. He mentioned other possibilities, but some things are not adding up for me.

[Neville86]

He said the words "I suspect ALS"? Also, what were the other possibilities?

[misterjuanperalta]

I asked in what clinical stage of diagnosis am I? He said, suspect. The other possibilities were radiculopathy and ms, though not an exhaustive list.

[Neville86]

Ok well that's a totally different thing. He didn't say he suspected you had ALS. You asked a rhetorical question, which really, let's be honest, had one answer. You asked what "clinical stage" you were at, meaning, "in the realm of ALS where am I?" And he said "suspect" meaning he can't say with 100 percent certainty "you don't have ALS" because of fascics and hyper reflexes. He never said you failed the clinical or even that he suspects you have ALS. It's like the time I had a clogged duct under my tongue, and I asked the doc "what stage of oral cancer is this?" And his response was the nearly the same "we have to run more tests before I can answer that question." You didn't ask "do you think I have ALS" you asked a much different kind of question.

[misterjuanperalta]

I guess so, but he could have said something else. I see your point in that I asked a close-ended question.

[Neville86]

Right. What did the other two neuros you saw say?

[misterjuanperalta]

There were no brisk reflexes in September neuro exam. Only one other neuro.