Quix and others...what do you think?

[monotreme]

Hi all.  Got my LP results back today.  Everything is normal on the CSF testing.  No bands were seen either.  However, the neuro noted I do not have ankle reflexes, worse on left, and when he did the babinski, my toes stayed up and no movement downward at all.  I also still have the positive Romberg and muscle spasms and extreme weakness on the left leg.  He said I definitely have some disease working on me, but he doesn't know what it is and my only option is to wait.  he did order a new brain MRI with and without contrast, physical therapy for my legs, and Provigill for my extreme fatigue (worse in afternoon).  he wants to see me in two months and said sometimes with neuro problems you just have to wait for things to worsen.  I have two questions:  do you think a 2.7 Tesla MRI is close enough to a 3 T?  second, what do you think of the doctor's recommendations?  Since the brain MRI done in March 2007 showed some demyelinating, foci and cerebral atrophy (mild), maybe the MRI will eventually get worse if I have MS?  Thanks....Craig..

[monotreme]

Hi Quix,  On the Babinski, my toes do not respond.  Since they are always pointing up and no longer curl or bend, they kind of just don't do anything when the doctor strokes the bottom of my feet.   I will go to the hospital in PA that has the 2.7 T MRI.  Also, today my wife called a physical therapist who does alot of work with the MS Delaware chapter and he is going to see me for a full evaluation as  a private therapist when he has an opening in three weeks.  He said he will give me his opinions and design an exercise program.  I am so afraid because I just can't walk more than 25 yards or so without leg spasms and numbness so I am hoping he can help me.  And yes I am an engineer (Ph.D) but with anything concerning medicine I don't think right.  I work in consumer fabrics patent law so I am out of the loop with machines lately!  Thanks so much Quix.....Craig  

[Quixotic1]

Hi, Craig, Thanks for speaking to me, I needed it.  Okay for the LP.  On the neurologic exam, I can't reconcile an absent ankle reflex with a + babinski.  But, are you saying that your toes didn't move at all?  If that is what you are saying, then then that would also be a negative Babinski, according to what I was taught.  Downward or no movement is a normal/negative test.  

As much as we would like to force the diagnosis to manifest, sometimes you do still have to wait.  I think we here often foster the belief that if we could just see that perfect doc or get that next needed test we will get our answer and on time.  I do know from practicing medicine that sometimes we do have to wait.  It sucks.

The indication of brain atrophy is still concerning, and I hope it isn't our first sign.  The PT is a great idea.  I had a dynamite PT and she really did allow me to walk semi-normally by making subtle changes in my gait and timing.

Ah...Provigil, it's great for me.  It is a stimulant, though I do not feel jazzed  or hyper on it.  It does allow me to get to the forum and pound out some messages and get a few things done around the house.  Otherwise they really would have to redesignate me as "ornamental" and I'm sure that would have tax consequences.  My neuro told me it has a long half-life (length of time for the level to fall in half) so take it by noon or you may have "bright eye" all night.

The increase in resolution as you increase the stregnth of the magnet in the MRI does NOT seem to be a linear one.  ie. by doubling the strength you get a 25% better lesion pick up.  I would think there would be little difference between a 2.7 and a 3T machine, but I AM NOT AN ENGINEER!!!!  March to now is a 6 month interval which is very appropriate.

I pray for some answers for you.  Quix