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Neurologist or radiologist?
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Neurologist or radiologist?

Problems getting a correct diagnosis, which I will go into in greater detail later -- but my general question is -- whose opinion would you consider to carry more weight -- neurologist or radiologist? Reason: CT scan was "abnormal" by radiologist, then "normal" by neurologist. So they referred me for MRI, to different place, different doctors. Same thing. Abnormal MRI according to radiologist, normal according to neurologist. I'm not entirely ignorant of imaging, and I have baseline studies to compare to, and no one seems interested in seeing the baseline images. The question is one of "generalized cortical atrophy". I know what it means. Should I get another opinion, or trust the "normal" finding (or pusue the "abnormal", for that matter?)

Part of the problem is that my medical records, unfortunately, contain an emergency evaluation that alleges that I was "embellishing", and this record is following me everywhere. As if being tense, terrified, and unable to speak at the time wasn't enough, thinking I was having a stroke, I must have been "faking", and now, it seems, I can't get taken seriously. I'm afraid to even go back to the doctor, but when my vision blurs every day on the left side, I have some right-side weakness, intermittent confusion, and feel "drunk" without having had a thing to drink, I get worried. Neurologist just threw some Topamax at me and said I probably had basilar artery migraine, or something realted to migraine, since I had a history of classic migraine with aura. But this is happening EVERY DAY. The Topamax helps a little, and I'm learning what foods to avoid, but I know enough that even so, this should not be a daily thing

Thanks.
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Avatar_f_tn
I would take all the films and get a brand new evaluation from another neurologist and radiologist.  Neuro's are good at reading MRI's but radiologists spent their entire schooling learning to read films.  You're right.  Those type of diagnoses follow you forever.  They don't seem to understand that these kind of symptoms are very distressing and most people are terrified and depressed by them, and rightfully so.  I would not bring any of that info with you to the new appt.  Just the films and the symptoms and let the doctor evaluating make his or her own decision.  If they ask for family doctor I would say none.  This way you will get a fair eval.
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Avatar_n_tn
I'm trying to get copies of all the records (I have the MRI on CD-ROM, and hard copies of the CT scan findings but not the films).

However, I'm also wondering the ethics of withhholding one's "other" medical history in the interest of finally getting some answers in this arena. I'm tired of people writing things of as "psychological". IF anyone could give this some serious thought: what would happen if I said nothing about any of my psychotropic medication, anxiety history, or any of this, in getting my second opinion?

Even though I have been in remission from psychiatric symptoms for many years, I have a history of anxiety and seasonal depression, and contiue to take medication -- so whenever symptoms are unexplained, the practitioner says they "must be psychological". This annoys me and my psychiatrist to no end, because by now we are both well aware of how my brain and body respond to stress, and THIS ISN'T IT. We are also well aware of my medication side effects, med changes, and so forth. These are not medication side effects. So far, no one has given me a full neuro eval from start to finish, just these little five-minute brief "once-overs". I've been in foll communication with my psychiatrist. He's quite annoyed at other practitioners constantly referring me back to him when we've been talking about this for a year.

Additionally, I made the mistake of asking the emergency neurologist if my symptoms could possibly be psychogenic in origin (i.e., conversion reaction), and ended up with the "embellishment" comment. I think my fear that they'll assume things are psych-related is at the root of that tension (although not related to the presenting problem), because a similar thing emerged in my primary care doctor's office the next week, when I was so tense that I had to close my eyes in order not to jump before the reflex hammer struck. Even then, my whole upper body was reacting to the patellar reflex tap. None of this was intentional. I assumed I would be given the benefit of the doubt, but it doesn't look that way.

Does insurance usually cover a second opinion?

Thanks.
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