What to expect at first appointment

[Meg1110]

What should I expect at the first appointment with the neurologist?

[doublevision1]

Good luck tomorrow, Meg.  Keep us posted on how you make out.

[Meg1110]

Thank you all! Tomorrow is finally the day and I hope to get some answers. My GP did bloodwork when I had my first "episode" and I was low in vitamin D. B-12 was good but she said to take B complex as well so I have been taking them for a while. So I've had everything check from Lyme to Lupus, thyroid, vit def, etc. I'm hoping for some answers...I'm not only physically drained but emotionally drained as well. Thanks again

[Ny3]

He/She may also draw blood to check certain vitamin levels (D & B-12). A lot of MS patients have been found to have low vitamin D levels and my neuro also checked B-12 due to the fatigue as well.
One suggestion, write down any and all questions you can think of before hand that way you won't forget. Good Luck to you.

[SarahL2491]

she might also order a round of blood tests to rule out many "mimic" diseases if your other doctors have not done so.  Usually the first round with a neurologist might last 1-2 hrs if they are a good one!  Make sure your
neurologist has worked with MS before or else you are wasting your time and
theirs.

double has given you some good stuff to look at.  If you have a timeline of your MS symptoms, that will help.  Keep it as brief as possible

[doublevision1]

This link will take you to a site that provides a excellent overview of the clinical neurological exam.

http://www.neuroexam.com/neuroexam/

[doublevision1]

One of our dedicated members/community leaders put together an excellent health page on preparing for a visit to the neuro:

http://www.medhelp.org/health_pages/Multiple-Sclerosis/Doctor-Visit-PREP---Be-Prepared/show/156?cid=36

[doublevision1]

The neuro will want to review your medical history and that of your family; your past and current symptoms which prompted you to seek medical attention; then, will conduct a clinical neurological exam.  S/he will also discuss the findings of any testing you may have had done, and may order further testing if appropriate, eg: MRI of brain and spinal cord (cervical and thoracic when evaluating for MS); lumbar puncture, evoked potentials.  

If initial MRIs were neg but neurological symptoms consistent with MS continue, s/he may order a repeat of the test.  It's preferable for repeat MRIs to be done at the same facility, on the same machine, and even conducted by the same staff if possible, for an apples to apples comparison.  An exception to his would be if the neuro wanted it repeated on a newer tech, higher strength machine which will pick up in  greater detail any abnormalities.  

In some cases there will be sufficient information gathered by and at the first appointment that a dx of MS may be made.  Conversely, there may be sufficient evidence to suggest MS is unlikely in which case further follow up is needed to determine the cause of neurological symptoms.

If seeing a neuro at a teaching facility, a resident will often conduct the initial patient history and neurological exam.  The supervising neuro will join in after this is done, and may wholly or partially repeat what the resident has already completed.