Neurosurgeon consultation

Had my appt with the neurosurgeon today. He hates the place where I had my MRIs done and wasn't impressed with those films (poor quality), but when he looked at the CT images (done at a different imaging center), he said that my symptoms might be caused by the t-spine compression occurring right across from the arachnoid cyst at T6. BUT...he said that it would be unusual and that my symptoms don't really fit the right pattern. He's sending me automatically for a second opinion before we commit to surgery. I also said that I wanted to wait until my follow-up MRIs to really rule out any CNS etiology, and he said he'd just go ahead and order another set of brain (MS protocol) and c-spine and t-spine MRIs with and w/o contrast. I hope my insurance OKs that (it's only been three months since my first MRIs), and if they don't, I think I can make a pretty good argument for covering it. "Hey, ya wanna pay for a complex spooky T-spine surgery or an MRI?"

He checked my reflexes and says I'm pretty hyper all over. Previously, they've been aysmmetric. He says I'm more hyper in my lower reflexes than in my upper. I also had a positive Hoffman's sign. I know that indicates upper motor stuff and is above anything that might be happening in my t-spine. I also have just read that some "normal" people can have this sign, but that it's generally indicative in the same way that Babinski's is. Does anyone have insight into Hoffmans?

That's it for now. Still in limbo, but I do like it that my doctors are talking to me and really working this up. I don't want this spine surgery (they have to go in through the ribs, and the recovery is at least a month, and I have three children, and there are some serious risks), but I don't want MS, either. What I do want is some answers and some....successful treatment? Something like that.

Bio

[essdipity]

I'm glad you're being taken seriously and had a good appt. The thing is, though, surgeons want to operate!  It's what they do!  Yours is being admirably restrained. I do agree that a lot more has to be verified before any such decision is made. That surgery is a really big deal, and I think recovery would be a lot longer than a month. The second opinion neurosurgeon will still have the same bias about surgery, so maybe you can get quite a bit more regular neuro input. Will the new MRIs be done with a 3-T? You need GOOD quality images.

ess

[Quixotic1]

I second ess' comments.  Sounds like you have a "thinking" neurosurgeon there. That's great!  Yes, it is true that a rare "normal" person will have a + Hoffman's and/or Babinski.  But, in the setting of hyperreflexia, it can't be written off as possibly normal.

The neurosurgeon has evidence that you have CNS lesion(s) above the thoracic spinal level.  It really makes sense to have the whole picture as clear as possible.  If he does this big-time surgery, and you are shown to have other major CNS problems (eg. MS) it will affect his "success" fate.  Also, it is good, prudent and proper medicine to be cautious as he is being.  I like to see that in a sturgeon.

Quix

[monotreme]

Cleveland Clinic has a spine center where doctors who treat spine problems medically look over your reports and MRI cd's.  

Last summer, I sent Craig's MRI films and reports to a Dr. Dimico (spelling??).  Anyway, he reviewed them and called me to tell me that Craig's leg weakness was not coming from the spine and to find a neuro.  All this and no charge.

Now of course the Cleveland Clinic neuro thought there was no neuro problem so go figure.

Good Luck,
Elaine