Went to the neurologist today

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centralnjgal
Regular Member


Date Joined Mar 2007
Total Posts : 71
   Posted 3/16/2007 3:33 PM (GMT -6)   
I've only did a brain mri.. He wants me to do c-spine mri, just to get the whole picture. He wants me to come back for an EEG, VER and a lower SSEP test...Can anyone shed any light on what these tests are set up to test for?
If I still have symptoms that don't get better and the mri is negative, he said we could do a spinal tap..
 
He won't diagnose me with MS unless he says he sees something on an MRI.
He thought it wasn't too soon that I did the MRI of the brain since I had symptoms eventhough the symptoms I had were only for a few weeks.
 
Is he doing things in the right order?
 
Eleanor

uppitycats
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Date Joined Jun 2005
Total Posts : 2135
   Posted 3/16/2007 4:11 PM (GMT -6)   
centralnjgal said...
I've only did a brain mri.. He wants me to do c-spine mri, just to get the whole picture. He wants me to come back for an EEG, VER and a lower SSEP test...Can anyone shed any light on what these tests are set up to test for?
If I still have symptoms that don't get better and the mri is negative, he said we could do a spinal tap..
 
He won't diagnose me with MS unless he says he sees something on an MRI.
He thought it wasn't too soon that I did the MRI of the brain since I had symptoms eventhough the symptoms I had were only for a few weeks.
 
Is he doing things in the right order?
 
Eleanor
The EEG, VER and SSEP all test nerve transmissions in your body, and depending on the results, will indicate whether you have a problem with the peripheral nervous system (things like carpal tunnel syndrome, or a pinched nerve in the neck, are problems with the peripheral nervous system. MS is of course a problem with the central nervous system).  The spinal MRI is done to see if there are lesions on the spine (sometimes they'll show up there before they show up on the brain), or other spinal problems that could be causing your symptoms.  The spinal tap is usually done last, mainly because it is so invasive, and there are sometimes painful side effects (a really ugly headache, fixable only by yet another invasive procedure). 
 
It sounds like he is being thorough, and testing for all the usual 'culprits' that can cause MS-like symptoms, if not MS itself.

...I am not a doctor, nor health professional, and don't pretend to be one, here.....


centralnjgal
Regular Member


Date Joined Mar 2007
Total Posts : 71
   Posted 3/16/2007 4:27 PM (GMT -6)   

Uppitycats..

I'm going to get a c-spine mri.. Are you saying that even if that's negative and symptoms persist, a spinal tap can detect what an mri can't.. If you are telling me that the side effects are bad, I don't want to go through with it.. What do you mean by another invasive procedure to correct the bad headhache? Is there anyway to prevent yourself from having a bad experience with a spinal tap???

 

 

Eleanor


Kimber
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   Posted 3/16/2007 4:39 PM (GMT -6)   
Hi Eleanor,
 
    Wow sounds like your doctor is being very thorough.  All the tests he is performing are those commonly ran if MS is suspected.  The spinal tap is usually the last one ran as it's not always necessary if enough information is found on the other tests.  It's a very evasive procedure compared to the others.
Here's some more infomation on the tests:
 
 
 
   
 
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centralnjgal
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Date Joined Mar 2007
Total Posts : 71
   Posted 3/16/2007 4:51 PM (GMT -6)   

Kimber..

You are a doll for being so responsive to me.. Thank you.. From what I hear about a spinal tap, I would be scared to death to get one from the side effects that people experience. I hope it doesn't come to that..

 

Eleanor


uppitycats
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Date Joined Jun 2005
Total Posts : 2135
   Posted 3/16/2007 5:42 PM (GMT -6)   
centralnjgal said...

Kimber..

You are a doll for being so responsive to me.. Thank you.. From what I hear about a spinal tap, I would be scared to death to get one from the side effects that people experience. I hope it doesn't come to that..

 

Eleanor

Many of us have had spinal taps *without any negative side effects*.  It is an invasive procedure -- the doctor is extracting spinal fluid from your spinal column.  Sometimes -- not always -- in fact, not MOST of the time -- some people experience a really bad headache after the tap is done.  The procedure to fix that is to return to the doctor, have him draw blood from your arm (like any other ordinary blood draw), and inject it into your spinal column, near the spot where the tap was done.  Almost instantly the headache is gone.

But again...MANY of us have had the spinal tap (or lumbar puncture...same test, different name) without ANY complications.  Usually the doctor will tell you to drink plenty of fluids before the test is done, and usually caffienated fluids (coffee, Coke, etc.). And then once the test is over, to lie FLAT for several hours, to give your body fluids time to readjust to the absence of the fluids drawn for the test.  Usually then you go about your business, with many only a slight backache the next day.

The test is really valuable, especially if all the other tests come back "negative", or "inconclusive", and you're still dealing with symptoms.  While the test in itself cannot diagnose MS, it CAN sometimes point to it, or to other things that might be going on in your central nervous system, like a bacterial infection (like Lyme) or chronic infection, or other disease mechanisms. 

If I were grappling with unexplained symptoms, and other tests have come back without any answers provided, and the doctor ordered a spinal tap -- I'd do it.  I've had 3 done over the years (for different reasons; the first to diagnose MS, as MRI's were not available then), and have never suffered any side effects except a back ache the next day.  After the first one, in fact, I got up off the table, got dressed, and went back to work...didn't know I wasn't supposed to...and had no ill effects at all.

By "invasive procedure" I mean a procedure that takes something from your body -- fluids, blood, etc.  The other tests are "external" -- you might have electrodes attached to your body, or endure being slid into the MRI tube - -but you leave the office with all the "stuff" inside that was there when you came in.  Doctors don't like to do invasive procedures unless there is no other way to try to figure out what is ailing a patient.  If all the other tests come back negative, or inconclusive, indeed a spinal tap might provide answers, or at least a direction, that the other tests didn't offer.


 


...I am not a doctor, nor health professional, and don't pretend to be one, here.....


Kimber
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Date Joined Jun 2005
Total Posts : 1852
   Posted 3/16/2007 7:13 PM (GMT -6)   
Hi Eleanor,
 
    Uppity is sooo good with detailed explanations!  Don't worry, there's a chance you may not need the spinal tap, but if you do there are measures to take that will reduce the chance of side effects.  You're always gonna hear a lot more of the bad experiences than the good ones anyway tongue  If you do end up needing one, we'll be here to support you and try to help ease that fear some.  Take care and good luck with tests!
 
 
Kimber 
 
Co-moderator for Multiple Sclerosis
 
Allow Healing Well to continue to help others, clink link for details

centralnjgal
Regular Member


Date Joined Mar 2007
Total Posts : 71
   Posted 3/16/2007 7:41 PM (GMT -6)   
Uppity,
Again, you are great when it comes to explaining things. The neurologist I went to is a Board certified neurologist, but has only been board certified for several years. If it comes down to a spinal tap, shouldn't I go to someone who specializes in MS and someone with more years of experience under his belt practicing to play it safe??

Eleanor

centralnjgal
Regular Member


Date Joined Mar 2007
Total Posts : 71
   Posted 3/16/2007 7:43 PM (GMT -6)   
Kimber,
I'm amazed at how well this site is managed and how kind people are including yourself. Thanks..So far this site has been a great resource for me..

Eleanor

uppitycats
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Date Joined Jun 2005
Total Posts : 2135
   Posted 3/17/2007 8:06 AM (GMT -6)   
centralnjgal said...
Uppity,
Again, you are great when it comes to explaining things. The neurologist I went to is a Board certified neurologist, but has only been board certified for several years. If it comes down to a spinal tap, shouldn't I go to someone who specializes in MS and someone with more years of experience under his belt practicing to play it safe??

Eleanor
Actually spinal taps can be done by good nurse-practioners, or other trained doctors. Neuros know how to do them, and some are more experienced than others, but you really don't need to search out someone who has been "board certified for several years", or an MS specialist.  Spinal taps are done for all sorts of reasons -- not just to diagnose MS -- and any competent neuro can do them, or can send you to someone they trust to do them.  Mine were done right in the neuro's office, without incident.
 
If the doctor does recommend a spinal tap, you can always ask how many he's done, and share with him your fears.  He'll likely be able to alleviate those fears, and even sometimes they'll prescribe a mild sedative so you aren't so anxious when the procedure is done.  So if you like your neuro, and he says he'll do it, I'd let him do it.
 
MS, by the way, is one of the more common neurological problems, and many neuros see lots of MS patients every day, in their practice.  This is another question you can ask your current neuro -- how many of his patients have MS? 
 
I, by the way, haven't been to a neuro for anything for years, now. My family practice doctor (who's speciality is "women and children", but she's my doctor and my husband's doctor) takes care of anything and everything related to my MS.  She has several patients in her practice with MS; she takes care of all of them, with only occasional consults with a neuro.
...I am not a doctor, nor health professional, and don't pretend to be one, here.....


Denda
Regular Member


Date Joined Jun 2006
Total Posts : 329
   Posted 3/17/2007 2:19 PM (GMT -6)   
Hi Eleanor -

I had 2 spinals in less than 2 weeks a couple months ago. My neuro does not perform this type of procedure, so she sent me to the local hospital. An anesthesiologist did it in the recovery room, he took 5 vials of spinal fluid and showed it to me. The fluid filled just a little over the tip of the vials. It was over in about an hour. I was told to go home and lie down for the rest of the day and drinks lots of water. No problems at all, a slight back ache like uppity stated, but that was it. No real pain during or after.

Well... 5 days after the test, my neuro calls me and tells me that the anesthesiologist didn't take enough fluid for the MS test, they got enough for all the other tests, but not the MS one, and told me I had to go in the next day for another one.

This time it took about 45 minutes, but the anesthesiologist told me that I more than likely will get a headache because he used a larger needle this time and filled the whole vial up. Told me to go home, and take it easy for the rest of the night, drink alot of water and caffeine drinks, alternating each hour. When I got home, I felt fine, just a little back ache, instead of lying down this time, I laid back in a lazy boy, drank lots of fluid, but went to my son's hockey game that night, when I probably should have kept my butt in the chair.

Next morning woke up with a slight headache, progressively got worse at work until the point of me leaving work crying and barely able to drive myself home. I called the anesthesiologist and he told me to lie down and if the headache persists until the next day, to come back into the hospital for a blood patch. I went to bed, stayed laying down for the rest of the night, as long as I stayed laying down, my headache was a dull roar and bearable, although the minute my head got above my heart, I would pray for my head to just fall off or just for me to die. It was horrible.

I ended up going back into the hospital the next day for the blood patch and the procedure took about 1/2 hour, but I stayed there for about 1 1/2 hours for a bag of fluid on top of the blood patch. As soon as the anesthesiologist put the blood into my spinal cord (or area of) it was like night and day, the relief was so wonderful. I can only imagine it was like a junkie getting a hit of whatever they are hooked on.


Now after all of that... Everything came back normal. BUT if I was asked to do it again for a dx, I would go through it all once again in a heart beat. I hope I didn't scare you, but I thought the details may help you understand how important this test can be for a dx.


I not only use all the brains that I have, but all that I can borrow.
  Author: Woodrow Wilson (1856-1924), 28th U.S. President


rhondab
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Date Joined Mar 2006
Total Posts : 2146
   Posted 3/17/2007 3:33 PM (GMT -6)   
Hey Denda

Wow...what a story! I'm really glad u posted this and allowed us all to see tha there are two very distint outcomes and a definite help for the headache should one have it. I'm sorry the lp wasn't fruitful for u, but in a way glad it didn't reveal ms either. Take good care and hang on!

Hey Centralnjgal

I can't really add anything to what's already been said here. Everyone's done a great job explaining things and giving u some insight, but wanted to tell u i'm here hoping and praying all will turn out well for u. Please let us know how the tests go and how u'r doing after the lp as well. Take good care.
rhonda
Co-Moderator, MS Forum
 
*~*Sometimes the Lord calms the storm. Sometimes He lets the storm rage and calms His child.*~*


centralnjgal
Regular Member


Date Joined Mar 2007
Total Posts : 71
   Posted 3/17/2007 5:52 PM (GMT -6)   
Thanks, everyone!
I'll keep you posted on my progress.
Enjoy the rest of the weekend.

Eleanor
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