Timed walking test? Part of usual exam?

[Joiedecour]

Something new at 6 month return appt today was a timed walking test. I have never had that before. Is it a normal part of neuro exam? The heel to toe thing has always been a few steps in the office - this was a dedicated room with a start and finish line!! Maybe they are playing with a new toy...

[essdipity]

Hi. Getting back to your original question, I have found that the timed walk is 'semi-standard.' The neuros I've seen all have included an evaluation of walking as part of their standard repertoire. Some, though, are more scientific about it, and time the walk to compare against previous testing. I think this is a good idea, personally. But it's just one of the many tests that neuros do, or should do.

I guess my walking time is adequate, though it's a bit slower than previously, something I've often noticed myself. My gait is slightly abnormal, as I drag my right leg to a very small extent. This is all consistent with other weakness on the right side, that has been measured and noted for years.

I'm just pointing these things out because together with a great many other tests and comments, they help give me confidence that the neuro knows what he or she is doing. For new members here, if your doctor does not do a very thorough office examination, he or she is not giving you what you're there for, so beware.

ess

[immisceo]

After about a year, mine resolved. I've not had that test in a while, but I've not had any vision issues since 2011 (besides the near-sightedness I've had since age 7!) so I assume that's still the case. After optic neuritis, they told me to wait a year before making any assumptions about what my baseline or 'new normal' was going to be. Luckily, both of my eyes are now equal.

[Joiedecour]

Imm, do you know if rapd comes and goes? I haven't been able to find anything abou that?  What I am wondering if this will count as sth new.

[immisceo]

I'm unsure what is indicating neuropathy because my RAPD/pale optic disc/optic nerve damage was caused by ON. But then, I didn't have the fun experience of duelling specialists. I'm so sorry you're getting crosstalk. That must be frustrating.

[Joiedecour]

Update. Annual optometrist appt. Referral to opthamologist. Dx after OCT and exam: damage to optic nerve, relative afferent pupillary defect, pallor of optic nerve. So not inflammation but neuropathy. Opthamologist thinks this changes the game. Previously dx'd ON by neuro who said 4 wks ago he could not see an RAPD. Scared more that these guys are missing the boat while permanent damage is happening than of the boat itself.

[Joiedecour]

do you really think so Alex? Does anyone else think I need a new neuro?
I like him because he reads mris, and spends time with me. But there was a point where I asked about a symptom, and his reply was that there was no evidence of a cause for the symptom on the mri. That seemed a little off to me, but then again, how much do theses guys give us a spiel because they think we don't know enough or want to mask something from us?
In the meantime, I know I need to find a way to get some at least temporary closure, so that might very well mean, just going along with this. Otherwise it's just too emotionally draining.

[HVAC]

I think you need a new Neurologist. I went to one and every test she did pointed to MS. One day I said "I feel like Alice going down the hole. I thought I was referred to you to look for MS" She took my chart and threw at her receptionist. She sent a letter to my GP saying she was positive I did not have MS. She had made an appointment with a neuro othalmologist. I told that doctor I was through with neurologists. She said you have MS so you have to go to a neurologist. I now know when you get to amaze or dead end you back out.

Alex

[Joiedecour]

Immisceo, thanks for info. I guess we'll see next year if he repeats the walk test, since I can't see how it could be useful now with nothing to compare it to. I wish I had thought to ask what prompted the introduction of this testing.

Not on DMDs, Sarah, just vitamin D and amantadine.

HVAC, no he's not new to me. He's been following me. And still wants to follow me. I did ask him when I could stop and he said he couldn't say.

I don't understand either, Alex. Initially it was 4 on very first mri, now 8. I think some of it has to do with the lesions not being in the right places and or large enough, and so the issue gets skirted around. I have stopped asking what else, because I just get a shrug, the migraine answer, or we don't know. I guess I'll just keep on keeping on, and, as Sarah says, either see what the apt in a year brings, or if something new happens physically.
I am just having a hard time with my head space for all of this, and the back and forth...

Thank you all for support and replies : )

[HVAC]

They always do the heal to toe. I only go ever two years now. I do not understand more lesions and not MS. I would have asked him what did he think it is if not MS. If he is new to you many neurologists like to make their own diagnosis. My MS Specialist often did not go by other neurologists I had.

Alex

[SarahL2491]

Usually, an annual visit means you've become stable and he doesn't need to see you as often.  I'm now on a once a year visit after 3 yrs of twice a year visits.

I've had to do the heel to toe but never the long walk.  I have mobility problems and a brace, so that would be difficult for me.  They might be picking me up off the floor if it was timed LOL

He may be, yes, waiting for another episode, noting an annual MRI.
Are you on any Disease Modifying Drugs?

Maybe time to let a little time go by and see what the next appt brings.

[immisceo]

Yup. This is a standard part of EDSS testing. Every visit I do a timed short distance test twice down a marked hallway and a 500m timed test once up and down the same long hallway.

Unsure about his hesitancy regarding an MS diagnosis. Perhaps he's waiting for a second objective episode? Seems quite conservative as an approach.

But considering 'angles' is a real thing as well. I have to have my head adjusted to the millimetre when I have MRIs for the drug study I'm on because otherwise comparing the MRIs over time becomes less and less accurate. A slice that is slightly on the bias (in other words your head was ever-so-slightly tilted) compared to the supposed same slice in a past MRI can make the same area of damage look much larger when it's in fact completely stable, for example.

[Joiedecour]

Oops! .. And he is a specialist but he has not given other explanations for sx.

[Joiedecour]

Not sure what to make of appointment with neuro today.  I like him, I think I trust him but he has dx'd optic neuritis, showed me 8 brain lesions, suggested that there has been an increase in lesions but suspects 'angles' or newer technology, wants to go to annual instead of biannual appts and mris and in response to my question says he doesn't think it's ms. I want to believe him, but should I? I like the guy an feel