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Another question

Was wondering if anyone can help. I have been told I could have a variety of different things from different specialists eg fibro, chronic fatigue, functional and I decided to take the wait and see approach. Last November I started to have back spasms which have knocked me off my feet for days on several occasions and just recently I was admitted to hospital with chest pains which I think could be connected to the back spasms. My question is this, can brisk reflexes and neurogenic bladder be functional. I am to be referred to another neuro and I would like to get a proper dx this time. I have lots of symptoms walking difficulties, numb leg and hands and now the back spasms, but I was dx with bladder and brisk reflexes and wondered if this would prove the not funtional bit.

I would also be grateful for any advice re a good neuro I don’t mind travelling to get some answers.

hiya…gosh sounds like you have had a rough time of it. I am no expert but no I don’t think a neurogenic bladder can be functional or reflexes…do you know if your bladder is under active over active? have you had any bladder tests…a neurogenic bladder is usually caused by nerve damage ie spinal or to do with the brain. or both even…Have you had any MRI of the spine/ brain. ? as far as I know and from reading others experiences then a functional disorder is usually only dx when all other avenues have been explored…and it just means that the nervous system isn’t working as it should but there is no identifying reason for this …sounds positive though that you are seeing a new neuro…perhaps be good to post what area you are from and any advice on a good neuro and they can pm you with details? equally back spams don’t just happen for no reason either…have you seen a physio about this? Is your gp supportive?

It has all been a bit of a saga really. I had bladder problems many years ago and underwent many tests before being dx with neurogenic bladder because of frequency and not emptying properly. I never really thought any more about it apart from it being a nuisance and lived with it. Years later I started having problems with mobility and left sided weakness. I had all tests done MRI was normal evoked potential normal blood tests etc and was given dx of fibro my doctor asked for another opinion and was told functional. I have seen rhemuy for arthritis and he dx possible chronic fatigue. So I decided to wait and see, but during this time I remembered dx for neurogenic bladder not just bladder frequency and also being told I have brisk reflexes. The back spasms are a new thing and very disabilitating and the physio I saw is writing to my GP suggesting a new referral to a neuro.

Another problem has been my GP because he is new (my old GP left the area) and he sees dx fibro, functional etc. and has not really bothered and I was waiting my time for new symptoms. Now I have letter from physio to support my problems and I hope for some answers. I want to be prepared this time with some evidence. Sorry if a bit of a ramble

As far as brisk reflexes showing abnormality goes, it kind of depends just how brisk they are because regular brisk reflexes can be considered normal; it’s hyperreflexia that’s definitely abnormal. Sorry - not helpful :frowning:

Is there any chance that the back spasms (and maybe the chest spasms) are actually something to do with your back? It might even explain some of your other symptoms. Have you had your back scanned? I’m asking because I’ve had this kind of thing, but it’s not my MS - it’s a couple of back conditions I have instead. (Incidentally, it took me several consultants, multiple tests and many years to get one of my back conditions diagnosed after finally finding a consultant who had a clue and sent me for a different type of scan.)

I hope the new referral gets you some answers.

Karen x

hi Karen

yes there is every possibility it could be my back, but I have had it scanned and was told I do have degenerative disc disease but no stenosis. Physio consultant for triage seems to think more neouroligical because problems in more than one area. I am not medic and have to rely on people I see, Can I ask what type of scan you had that led to a final dx regarding your back? Greatly appreciate your advice.

It was an isotopic bone scan. I remember the diagnosis as spinal haemangioma, but that’s actually quite common and doesn’t generally cause problems so I guess I’m missing a word or two! Basically I had internal bleeding in three of my vertebrae. It isn’t operable because of the risk of bleeding out so I had radiotherapy on the main one causing the trouble (my T8) to scar the open vessels and stop them bleeding. It didn’t seem to work all that well in the beginning, but gradually things improved and I now only have quite mild problems from it.

The thing that reeeeeeeally p’s me off is that I recently found the spinal scan I had done several years before that and had a wee look. When I had it done, I knew nothing about MRI. Now I do I can clearly see the problem on there - a whacking great white spot almost entirely covering my T8! How the hell the radiologist missed it, I have no idea!

The proper dx was a long time ago and MRI scanning has moved on massively so I don’t know if the isotopic bone scan would pick anything extra up, but you never know unless you ask!

Karen x

HI Karen

Thank you for this information it is certainly worth knowing when I see a specialist again, but how would the neurogenic bladder fit with this though considering I had that long before any other signs of back or mobility problems.

I guess it is possible for you to have something similar to my back thing, but it wasn’t really what I was suggesting - just that it might be worthwhile considering if your back could be causing at least some of your symptoms.

When I had my first proper relapse, I was referred to a neurosurgeon because the GP and I assumed it was my back again. Even the neurosurgeon thought it might be a new haemangioma which was affecting the spinal cord. Turned out to be MS of course. The moral of the story is that anything that interferes with the spinal cord can cause neurological problems - and there is a wide range of anatomical stuff that can do it.

Kx

Hi again…thanks for filling us in in things…and as Karen says there are many neuro causes for back probs and some symptoms that arise frrom it. It still baffles me that however good an MRI is, its open to interpretation and the dr who does the report may not spot everything and the consultant who ordered it may not either and a neurosurgeon won’t be looking for the same things as a neurologist. my brain MRI without contrast in feb threw up some age related things but the radiologyst didn’t spot the inflamation on left optic nerve but the eye neuros did after checking in two occasions…so as precise as MRI are it depends on who is looking at it too…Does that make sense? as Karen says structural things can cause probs …damaged nerves from various causes and each spine is different in its make up and some times Mother nature doesn’t always get it right either and this can cause problems…can I ask have you ever had any injury or trauma to your neck or spine? em

ps a neurogenic bladder could be either due to brain/ bladder or spine/ bladder. or both perhaps…not sure on that myself…I have retention of urine and loss of sensation after an rta in 1994 I had severe whiplash of whole spine, head injury and was laying down in the back of a van when a coach ran into the back of van. I also had. whip,ash in 97 and 98 retention of urine can be gradual thing or can be acute but in my case it was gradual…starting in 98 … I have a birth defect in my spine where one vertebrae grew much smaller than normal I also havean extra one too…not symptomatic before rta but recent neurosurgeon thinks this became symptomatic after the trauma and sunpbsequent whiplash…and he thinks I havea tethered spinal cord as a result of the spina bifida acculta…and if this is confirmed in MRI then is most likely cause of my leg prob, back probs neuro probs and bladder too!! I had an MRi in 1994 and if it was there then it was definately missed by the neurologist lol em

I was in my early twenties when I started bladder problems -no accident or injury of any kind. I underwent lots of tests checking emptying etc, and camara insider bladder etc and was given dx neurogenic bladder. I never thought of why at that time I just accepted it but it has been very annoying.

I had a problem with severe fatigue for several months after I was first married and after birth of both children but I just thought because of new routine, working plus own house etc. never followed it up. I have never been able to do late nights.

Probems with my wrist and not able to write was another mystery that went after several months of wearing supportive brace.

I did injure my back slipping down several stairs and consequently everything that followed from then I thought was due to my back. I was later hospitilised because of back and neck causing weakness down left side.

It was after a bout of inability to walk far I became aware something was far from right. MRI of spine showed degenerative disc problem but no stenosis therefore I was given a dx fibroymyalgia. We are of course moving on in years at this point I was in my early 40’s.

To cut a long story short I began to think differently and was referred to neuros who dx functional because normal tests and I did not have LP because I must admit bit scared of the thought of that,

Now with new symptom of back spasms I feel ready to have another round of tests. The other day I was reading an old report from neuro to my GP and he mentioned me having bladder problems for no known reason , this of course was not the case. Hence my question to you all before I go to see another neuro does a neurogenic bladder prove not functional and do you think it would show on MRI after all this time.

I do appreciate all your input and I am fully aware that I probably have more than one problem but I just want to be fully clued up this time. I really do appreciate all your advice.

ahh ok thanks for extra info…hopefully the new neuro will take into consideration past tests and findings and equally be objective too… I really don’t know ifa neurogenic bladder can be functional of nature…I think functional probs can arise in any area of the body…at anytime… because the nervouse system is complex and governs everything. equally if no known reason cannot be found doesn’t mean there is not a physical reason for this and it may well be a good idea to be reviewed on this aspect as well…and prob new MRI would be good idea and if they offer an LP then I would go for it…then all bases are covered… the nerves from the bladder to the spine and to the brain are complex…and it’s not always possible to know if any connections are wrong without further tests so I would push for these…also your new symptoms need to be looked at as equally as your past ones and the whole picture needs to be addressed. maybe you could ask the neuro if a neurogenic bladder can be of a functional nature…? it’s ok to ask questions…and you need to make the best of your time with them…