Hyperreflexia, Hyporeflexia, Hyper spasticity & abnormal babinski

[thester6474]

I went and saw my PCP today, I see him every two weeks, since he has me on medical leave..I think he is awesome, and wish that all physicians were as caring and sympathetic as he is...Today he decided to check my reflexes again...He noticed in one of my knees I had hyperreflexia, in the other I believe he said hyporeflexia..When checking the reflexes of my elbow, he noticed that one hand moved slightly (the thumb did not), and the other one did not.  He also noted an abnormal Babinski Reflex in my right leg only...Today he also took something and stuck me several times, he wanted me to nod when I felt it...In some areas I couldn't feel it at all, he actually had to tell me when he was sticking me (he said he was stabbing it against my skin), in other areas I barely felt it, and in others I clearly felt it...He said that it was definetly lateralized...I do not know exactly what he meant by that, but like I said I truly respect this doc, he is awesome...What does he mean that it was lateralized, and which side of my spine or brain would you feel would be most affected (considering the babinski reflex is on my right side)?  What conditions could cause this?  He has now stated that he wants me to go further for diagnosis and treatment..He wants me to see a group of Neurologists at either Duke or Emory, both of which are hours and hours away...He must really think that it is serious...

[Quixotic1]

Hi, again.  You are so lucky to have a doc that is caring and thinking and planning the best!

Lateralizing signs are those that indicate the problem is localized to one side or the other of the central nervous system.  This distinguishes them from generalized symptoms that indicate something is evenly and diffusely affecting the nervous system.  It's not that important for us to try to understand exactly where the lesion is - right or left - but more, it narrows the possibilities to those disorders that cause individual lesions.

The + Babinski sign indicates that the problem is central in the spine or brain.  MS is the most common one, but none of this say directly it is MS.  Follow his recommendations and go get the eval, even though it is hours away.  The trip will likely be well worth it.

Quix

[Heather3418]

Your PCP is trying to make sure that he sends you to the most knowledgeable Neurologists, right off the bat.  No fooling around.  It's not that "He must think that it is serious."  He is trying to get you the quickest possible answers on the first try.  Again, showing what a caring PCP you have.  

I was told that my hyperreflexia was caused by possible lesions or narrowing (spinal stenosis) in my spinal space.  I had a positive Babinskil sign in my right foot on my very first Neurological exam.  I also had the "needle" test along my right torso from my neck down to my waist.  I could not feel the needle pricks.  I was sent for a spinal MRI within a week.

It showed a lesion on the right hand side of my spinal cord.  Hence, why I was numb on the right side and why my right foot showed the Babinski sign. After this MRI can back with a highlighted, active lesion in my spine, I was sent for a brain MRI with and without contrast, which also showed five, currently active demyelinating lesions in my brain.

I would follow your PCP's suggestions to go to Duke or Emory to be checked out, which hopefully promises to provide the information he is looking for.  You have a great PCP.  Try not to worry....you are in good hands, obviously

Best Wishes, Heather