Doctor can you help

test results what do you think
by HARRYBEADS


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HARRYBEADS
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Mood: HARRYBEADS is missin his bike
  



, Mar 13, 2008 11:07PM
I would like to know what the Doc thinks of these results of my neurological test.I will not be seeing the Doctor for a month or so and I'm loosing it with worry.
                                                                                                                                                          

- had a mild action and resting tremor

- deep tendon reflexes were 1+ across both upper extremities but hyperactive 3+ across both knees and 2+ across each ankle

- plantar responses were equivocal, as he displayed very strong withdrawl (withdrawal) response

- obtained more than 5 beats (or bits) of sustained clonus across each ankle , whats that mean???

- considerable spasticity across both lower limbs

- large amplitude clonus on hip flexion

- abdominal reflexes, failed to elicit them on left side


- evidence of upper motor neuron pathology, whats that????

- Mcgill pain questionnaire, selected 9 of 15 words from severe pain category and 4 from moderate, what does that mean ?


thanks, I know your busy but please fit me in

Harry

[Abhijeet Deshmukh, MD]

Hello Harry.

I apologize for the delay. There are so many posts here. The front page changes every minute.

Well, over all, the results show that you have some upper motor neuron lesion. Upper motor neuron and lower motor neuron are descriptions for the level of nerve cells that travel from the brain to the periphery and vice versa.

The signals for any movement of a body part are carried by motor neurons. The first neuron (Upper motor neuron) starts from the cerebral cortex (also called as gray matter). It has a long tail that travels through the spinal cord and meets the second stage neuron at the level it is supposed to branch out to that particular body part. The second neuron is the lower motor neuron.

The upper motor neuron also has an inhibiting effect of the lower motor neuron. Something like the elder brother has a control over the younger brother. If there is a problem with the upper motor neurons, this inhibition is no more active. The lower motor neurons behave as if they are autonomous, just like the younger brother. That’s why you get the enhanced reflexes and the spastic limbs.

Ankle clonus is also a part of the upper motor neuron loss manifestations. You may have observed the doctors testing ankle clonus on you. Less than 5 beats are not considered significant by many physicians.

The abdominal reflexes are not working on the left side. You may be having a spinal cord lesion at the mid thoracic level.

How about any MRI of the spine?

Regards

[HARRYBEADS]

Thanks for the great explanation,even I understand it, MRI of my noggin is scheduled for next week, spine in late April, and a full work up to be arranged. I'm scared scatless about the spinal tap.
  They started me on lyrica for the pain and it is helping already.

   YOU GUESS MS ?


thanks it's worth the wait, hope you get good pay for putting up with all us

Harry

[Abhijeet Deshmukh, MD]

Hello.

It will be too early to say this is MS. First let's rule out a spinal lesion. A spinal tap will be immensely helpful.

Regards