PSYCHOLOGICAL vs NEUROLOGICAL DISORDER (+MRI & + EMG)

Posted By Kelly on July 10, 1997 at 05:14:47:









I will open with "I believe that there is no truly unknown disorder; someone, somewhere, has either experienced the disorder or knows of someone who has!!"  
To begin, let me rule out any mental health issues to the reader of this posting.  I went through an extensive 7 month psychological evaluation; condcuted bi-weekly to have the clinical psychologist write the phone DSM V dx:
AXIS I: Personality change due to Neurological Disorder, Disinhibited Type
AXIS II: NONE
AXIS II: Probable degenerative neurological disorder, final diagnosis pending
In addition, a complete NEUROPSYCHOLOGICAL evaluation was performed and summary read as follows:
Psychological status: No evidence of mood disorder nor other psychiatric disorder.  A high degree of concern with health status was found, along with acknowledgement of poor anger control.
SUMMARY: LEFT HEMISPHERE AND FRONTAL LOBE DYSFUNCTION, DEFICITS MOST CONSISTENT WITH A PROGRESSIVE NEUROLOGICAL DISORDER
** AT END OF 5 PAGE REPORT, WROTE COGNITIVE DEFICITS RANGE FROM MILD TO SEVERELY IMPAIRED!
YOU HAVE THE BELOW MRI & EMG REPORTS:
EEG's only showed focal abnormalities.
2 MRI's REPORTS: There are five subcortical white matter punctate foci of abnormally high signal in the left frontal lobes and two punctate foci of abnormally increased signal in the subcortical white matter of the right frontal lobe.  These foci are of uncertain significance and may reflect a residual of previous trauma, resulting from a demyelinating process, or possibky reflect averaging with adjacent cortical gray matter.  Foci of abnormal signal are only definitely identified on coronal images
IMPRESSION: Several punctate foci of abnormally high signal in the subcortical white matter of the frontal lobes bilaterally.  The foci are of uncertain significance and may be related to previous trauma or possibly a demyelinating process.  Clinical correlation is advised.

EMG REPORT:
CLINICAL DIAGNOSIS:  FASCICULATIONS AND MYOCLONOUS
Summary of Findings:
1. The sural was slightly slowed in latency.  The superficial peroneal, median, unlnar and radial sensory studies were all normal.
2. The peroneal, tibial, and median motor studies were normal in all measured parameters.
3. The peroneal and median F responses were entirley normal.
4. An EMG was performed on selected upper and lower extremity muscles and demonstrated mild amounts of fasciculations without any other evidence of membrane instability.
CLINICAL INTERPRETATION:
This is essentially a normal electrodiagnostic study with only minimal fasciculations noted scatter in both the lower and upper extremities without appearance of acute membrane instability nor accompanying neuropathic motor unit potential changes.  Additional the sural latency was minimally prolonged in latency.  Clinical correlation is recommended.
The neurologist prior to sending me Walter Reed, had said my seizure disorder was consistent with "complex partial & myclonic focal seizures" but the EEG's only showed focal abnormalities.  
MY OWN DESCRIPTION OF WHAT HAPPENS WITH SEIZURE ACTIVITY I EXPERIENCE:
I have almost daily myclonic jerks brief 1-2 second jerks of the upper body, sometimes with jerks have uncontrolled vocalizations, utterances of no definable speech, but that only happens at the most once a month.     When I have experience a seizure, I do get pre-feeling as though something is about to happen, then sometimes I don't get the pre-feeling. Then will shake violently for about 5-10 seconds in duration.  Usually aware of my surroundings,  but have been told both by family and coworkers will appear drunk afterwards.   I have a lot of "deja'vu experiences"   Periodic leg movements during sleep, and possible apnea, wife reported to neurologist's that periodically gasp for air during sleep.
To bring this email to a close, I guess with all the documented medical reports (MRI, EMG, NEURO-PSYCH, PSYCH EVAL) and only focal abnormalities on EEG's should portray a compelling picture that might problems are not psychological, but
real.   However, I was told at Walter Reed my neurological symptoms and seizures are due to a chemical imbalance and wrote the final diagnosis as "psychological factors affecting physical condition" and gave no treatment or medicines to control my seizures.