New here! Question about "vibration" neuro test

[Jifr]

Hello All:

I found this site today and I'm new here!  I'm sorry if this turns into a long post!  It's good to find someplace where I might get some answers.....

Dx in 4/2002 with both brain and spinal lesions.  My spinal MS is worse, of course.  I'm in Cincinnati and see a neurologist at UC.

I am currently have a flare that my neuro believes is related to a new lesion in my low C or high T spine. Current symptoms border on "useless hand".  After some numbness in pinky and ring finger, I started loosing fine motor ability I'd guess you'd say.  I was dropping stuff, had difficulty typing...holding a knife/fork..issues trying to grasp things.  I had some odd issues with my bicep and that's how I noticed this all starting.  When I yawned...my arm curled up.  I got scared when I went to push a button on the radio, stuck my arm and finger out..and missed the button.  My hand went to the left of the button.  I had to stop and concentrate and was utterly floored when it happened again.  I went around pointing and trying to touch stuff but.........COULDN'T.  ::deep breath::  How can you MISS a target you're specifically aiming for..thinking about pressing...and it NOT happen?!  This is part of the reason my neuro is sure I'm having a flare and where she thinks it originates from.

My question...

I need to know what the test with the tuning fork type tool is called.  It's the one where they hit the tool and it starts to vibrate.  They put it on different parts of your hands/feet and ask you if you can feel it.

I also need to know what the significance is if you CAN'T feel it.  

My Neuro performed this test at my last appointment and I could feel it everywhere except my lt hand.  She tested near my knuckle of my index finger.  I actually asked her if the tool was "on" when she tested there because I was shocked that I couldn't feel it.  She hit it again, tested my right hand to make sure I could feel it and then moved it right over to my left hand.  I was kinda stunned, to be frank.

Also, I've never really known what qualifies as MS "pain".  I developed an extreme sensitivity and pain to everything on a patch of skin on my arm and forearm.  It "feels" like an ITCH but...I can't TOUCH it.  I can't scratch it.  It's mind boggling.  When it is hurting...I touch the area and the terrible sensation starts.  I don't know what to call it, though.  Does anyone have any idea what to call this so I can explain it to my neuro?!  I'd like to get that taken care of.

I've had the problem, I don't know what it's called, where I will "feel" an itch or like something is on my skin and I go to scratch it - only - the itch is not where I THINK it is.  Does that make sense?  I have to kinda feel around to figure out where it is.  It'll be itching...but I don't know where it is.  Is there a name for that?

If you made it to the bottom of my long post...thank you.  I appreciate any feedback, comments, pointers, tips, recommendations...you name it...I'm appreciate.

Thank you!

Jifr

[jensequitur]

There are two kinds of numbness - fine touch numbness and the less sensitive pain/cold nerves.  Many times in MS patients the fine touch nerves are damaged and no longer work, but the pain/cold nerves still work just fine.  This is why a numb patch can be numb if touched lightly, but wake up if you slap it or pinch it.

The skin itch sounds like hypersensitivity - just like numbness, it's caused by damage to the nerves.

As for what the test with the tuning fork meant, well, it sounds like you're very numb in that area.  Did she also do a ***** test?

[jensequitur]

Whups, forgot about the automatic sensor.  That would be a p r i c k test.  The neuro pulls out a little plastic tool with very sharp points all around a wheel, and rolls it around on various parts of your body to see if there's any sensation.

[Wobbly]

Hi there..I just wanted to welcome you to the forum.  You found a great place to ask questions, but I'm sorry i can't help out with this one.  

Check out our "Health Pages" the link is on the top right side of this page..there is alot of information there that you can find answers too..

take care and tell us more about yourself.
wobbly
dx

[Quixotic1]

HI, and welcome to the forum!  I'm glad you found us.

Your questions are pretty straight forward.  The vibration test is called the Vibration Sense Test.  Vibration is one of the 5 senses for which we have separate nerve fibers and nerve endings.  The others are light touch, hot/cold, pain, and position, though many include discrimination also.

Light touch - soft touching with a soft object (subjective to patient report)

temperature - can the person feel that hot is hot and cold is cold (subjective)

Pain - can the person feel a pin pr ick?

position - can the person feel if a toe or finger is moved up or down?

Discrimination - When two areas close together are touched, can the person tell that there are two points.  How close together can the person perceive?  (note - Normally a person can feel two separate points closer together the more toward the head the test is done.)

Vibration is just another sense.

The "phantom itch" is a common false signal from a group of sensory nerves.  Where the nerves start - the itchy skin - they are normal and the skin is normal.  But, somewhere on the way to the brain the signal is damaged by the MS and causes what is called a Paresthesia.

Here is an article to read about paresthesias:

http://www.medhelp.org/health_pages/Multiple-Sclerosis/Paresthesias---Things-That-Go-BUZZ-in-the-Night/show/378?cid=36

Ask away.  There is no reson you should have questions about what is happening to you.  And welcome to the clan!

Quix, MD

[Jifr]

Wow.  Thank you!  

I'm going to through a flare right now and my symptoms seem to keep jumping all over the place...and, while I USUALLY take my MS and the symptoms that remain in stride...right now, I'm scared.

Some MS'ers say that a lot, though.

I've never had this "transient" symptom thing before.  Well - actually, when I had hemi-facial spasms - it started with an eye twitch and gradually progressed to the rest of the left side of my face.  That lasted 6 months - until I ran into a dr at an MS expo who took one look at me and said "botox will help fix that".  I switched docs, got the botox inj..and now my face only twitches if I smile too much too long, if I have a drink (I'm a total lightweight), or if I am hot/stressed or tired.

The newest transient symptom is what I believe are fasciculations.  Super fine muscle tremors?   Is that right?  Those started today.  I was standing at the counter holding a piece of mail and noticed that it was shaking.  I switched hands and it didn't shake in my other hand.  I switched back...(very scientific approach here)...and the shaking started again.  At first, I couldn't "see" the shaking.  I could see the PAPER shaking...but not my hand.  But the longer I held my arm in that position, the more my hand started to be visibly tremoring.

And, how's this for making my own stress and probably causing this...

I got the MRI CD after my MRI on Thursday.  My MRI was in a 3T.  Seeing a 3T MRI vs a 1.5T MRI is like watching TV in regular or high def!  After you've seen HD - you wonder how on earth you ever watched that fuzzy ol' regular def tv.

So, I looked. Of course.  I always do.  I know where all of my lesions are/were and wanted to see.  Which....probably was not a good idea in hind sight.

Because...you can see so much MORE.  So much.  At least to my research and experienced trained eye.  I sat down with my neuro once and had her point out the lesions on the MRI so I would know what they looked like.

So, armed with my "knowledge", I looked.  And...wow.  How on earth I am still walking at this point is a miracle.  At least - that's the way I felt after looking at my MRI.  There were lesions ALL up and down my C Spine.  C2 lesion doesn't look like it's going to stay the current reigning "rather large and impressive" lesion my doc used to call it.  It LOOKS like my entire C spine has 5-6 lesions.    I think 1-2 are probably new...or were never imaged in the 1.5.  I see some definite newly imaged lesions on the brain scan...but, again...maybe it was always there and just never imaged on the 1.5.

I have until Thursday morning to keep scrolling through those pics to come up with a fairly good idea of what's going on before my doc puts me in my place.  lol.

Am I rambling again?  Oh, look, it's 3:30 in the morning. Maybe I am.  lol.

Quix - you made my morning.  Thank you ever so very much and I'll keep asking!

.jifr.

[Jifr]

Hi there!  My doctor actually took out a safety pin! (not the wheel spoke thingy).

She started lighting - well - stabbing me - since we can't use that other word (lol)...on the palm of my hand.  I could feel the sensation of something there but I told her it's like there's something over my skin - like a rubber glove.

I could feel the sharpness on other parts of my skin on the same arm though.  I think I've got the same thing with hot/cold, too.  I got a large soup to take home for dinner this week.  When I took it out of the bag, I started to get mad because the soup wasn't even hot!  Or so I thought.  I set it down to do some other stuff and when I came back I picked it up with my other hand.  Guess what?  You probably guessed.  The soup was VERY hot.  How's that for yet another discovery?

I'm on a transient symptom roll this week.  Maybe the steroids will start to kick in and knock tis flare out for me.

::fingers crossed::

Thank you for taking the time to read and post something so helpful!  I'm going to have a better idea of where to direct my research and questions!

.jifr.

[Jifr]

Hiya:  I think you're right on with the hypersensitivy.

...I did some research and came up with "Dysesthesia" as a name for the hypersensitivity I'm experience.

I think the other tremors in my right arm are positional though.  Could that be?  I only visibly tremor when my arm is in a certain position.

T-minus 2 days until I get all the details on my 3T MRI results.  I might call today to get a copy of the report...

[jensequitur]

Hey, the shaking of the hand is almost certainly an action tremor.  I get those in my right hand, although recently they haven't shown up unless I'm tired or overheated.  

Action tremors happen when the muscle is being used.  Think of it as an electrical signal to the muscle.  Normal nerves transmit the electricity as a constant ZZZZZZT.  But when there's a tremor, the nerve is actually going ZZT-ZZT-ZZT-ZZT.  

[Quixotic1]

Jiffer, I agree with Jen that the fine shaking you describe is a very fine action tremor.

Fasciculations are those tiny contractions that you see or feel under the skin  like a lot of people get around the eye..  They don't cause movement in a limb.  It is just a small part of a muscle that is contracting intermittently.

Quix

[DawnYM]

I hope you start to feel better soon!!! Sorry you had to meet the forum family this way!!! And prayers for you!!

[Guitar_grrrl]

I often get fasciculations in my quads, usually while my calves or feet are in full blown spasm.  Also, in my biceps when my hands are in spasm. OWWW!!  It's been better with Baclofen.

Feel Better Soon!
Guitar_grrrl