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anxiety regarding lumber puncture!!!!

Hi

 

Has anybody been diagnosed without a lumber puncture being done? .......I had or they tried being a better way to put it yesterday it was the most awful experience I have ever had he (juniour doctor apparantly)  had at least 8 or 9 gos and used 3 different needles never experienced anything like it ,  felt like the worst ever electric shocks running down my leg I was in ears and said stop enough is enough......he was unaware of the herniated disk I had till the end cause I told him, surely it should have been in my note?!!!

Anyway neuro was told and spoke to his secretary and she said hes not going to put me through that again.......to take the course of steriods he gave me and be back to see him in 2 weeks......I have had an MRI which showed areas of deymyelination which one is in the area of my presenting symtom which is why I was refered a drop foot!.......can a diagnoses be given without a lp does anyone know?......I have been in limbo land for 3 months and the anxiety is sooooo bad feel like Im going insane......you worry if not ms than what else and is that worse.......emotions all over the place, would like to just have some kind of normality and not have this hanging over you 24/7.

 

So if anybody got any advice I would be very grateful..

 Thanks

 

I didnt have a lumbar puncture.  Had two separate episodes of altered sensation (first leg, then arm) and the MRI showed several lesions.  That was enough evidence.  I would have declined a lumbar puncture anyway as the thought terrifies me.

Hi EARitchie

Sorry you had such a dreadful experience. I had an LP last July and it was a really positive experience. Just a sharp scratch for a local anaesthetic and some pressure for the LP. No ‘headache from hell’ and back to normal the next day.

I was lucky to have an expert doing the job. I hope most of you get the same.

Teresa xx

Hi

I was diagnosed from just an MRI, I was in a really bad way and couldn't walk at the time.

My neuro wanted me to have a LP at the same time but I said that I really didn't want to unless I really had to, as I was terrified at the thought of it and felt like c**p - he said I could wait until after I'd started to come round from the relapse. He's never mentioned it since ... phew!! 

I hope you get sorted soon .... the emotional stuff does get better with time

Ruth xx

 

Refuse to have one; don't need them if you show at least two lesions separated by space (different places) and time (at least 2 hours between attacks that is enough for a diagnosis.

 

With other caveats e.g. you show other clinical signs. There are many different neurological tests and the ones your neurologist chooses to perform will depend, in part, on the symptoms that you present with. Here are some of the more common ones.

Romberg's sign: This is a test for ataxia (incoordination or clumsiness of movement that is not the result of muscular weakness) and involves standing with your feet together with your eyes closed. Ataxics have great problems standing still under these conditions.

Gait and coordination: The neurologist evaluates ataxia in various parts of the body by observing the patient walking normally, walking heel-to-toe and finger-to-nose tests. The neurologist will also be looking for intention tremor (shaking when performing small motor movements) as well as ataxia in this last test.

Heel/Shin test: This is a test for ataxia and cerebellar dysfunction. You have to bring the ball of your heel onto the knee of your other leg and then move it down the shin.

L'Hermittes sign: This is a test for lesions on the spinal cord in the neck. The neurologist will ask you to lower your head towards your chest. A positive L'Hermittes will generate buzzing, tingling or electrical shock sensations in one or more parts of the body.

Optic Neuritis: This is a condition of the eye caused by inflammation and demyelination of the Optic Nerve and is perhaps the most commonly presenting symptom in MS. The tests involve the ubiquitous reading of letters from a board and a test for colour vision using an "Ishihara" colour chart. An examination with an opthalmoscope will reveal pallor of the optic nerve in old optic neurites.

Hearing Loss: This is done by lightly clicking the fingers next to each ear and asking the patient which ear the click was done next to.

Muscle Strength: This involves resisting the neurologist with various muscle groups. Differences in strength between left and right sides are easier to evaluate than symmetrical loss unless the weakness is severe.

Reflexes: This is done with both ends of the hammer. The reflexes can be normal, brisk, i.e. too easily evoked, or non-existent.

Babinski's sign: A test for signs of disease process in the motor neurons of the pyramidal tract. The test involves drawing a semi-sharp object along the bottom of the foot. The normal response in adults and children is for the toes to reflex downwards (flexor response). In babies and people with neurological problems of the corticospinal tract, the big toe moves upwards (extensor response).

Chaddock's Sign: Similar to Babinsky's but testing for lesions in the corticospinal tract. The neurologist touches the skin at the outside of the ankle. A positive response in upwards fanning of the big toe just like in Babinski's test.

Hoffman's sign: This is also similar to Babinski's but involves the hands rather than the feet. Again it tests for problems in the corticospinal tract. The test involves tapping the nail on the third or forth finger. A positive response is seen in flexion of terminal phalanx of thumb.

Doll's Eye Sign: The neurologist is looking for dissociation between movement of the eyes and of the head. A positive response is when the eyes moves up and head moves down.

Sensory:  This is done with tuning forks and pins and tests the level of sensory perception in certain parts of your body. 
 

If you are forced to undergo another here is what I usually advise.  The actual procedure is not painful; in fact the only thing you feel is a scratch when the anaesthetic goes in.  The actual removal of fluid is just a feeling of pressure if done properly.  I must stress if done properly; do not let anyone practice on you insist on someone who is experienced.

 

It’s after you MAY get something called ‘the headache from hell.’  To cut down the chances of getting this you should lay flat for at least 3 hours do not even get up to go to the loo; use a pan.  Drink at least 2 litres of classic Coke, not diet; it’s the caffeine that aids replenishment of your CNS fluid.  Being your drinking a lot take one of those bendy straws otherwise the bed will get more Coke than you.  If you want a change of drink very strong coffee.

 

These things will drastically reduce your chances of getting a headache that could last about 8 days.  If you have a couple of days off work and rest if you do not get the headache, if you do 10 days off work.

 

If the headache last more than 10 days you could need a blood patch; especially if there’s a wet patch on the bed in the area of the spine after a nights sleep.  See GP;  http://www.rcoa.ac.uk/docs/hesa.pdf  this is rare. 

 

Good luck.

 

George

 

 

I was diagnosed without an lp or an MRI but that was 16 years ago. I did have an MRI but only later on just so he could put something in my notes. I was already on betaferon by the time I had MRI.
Cheryl:-)

Hi,

I was dx without having a LP as the neuro said she didn't think it would show her what she needed. My dx was based on history, MRI, VEP and many many tests. So the simple answer is no you don't have to have one done.

Wish you the very best.

Janet

Thanks everyone for your response it really is a rollercoaster of emotions most of them being crap!!! on the plus side Neurologist says being 42 is a positive thing (glad getting older has benefits eh) and that L'Hermitts sign (bit technical) I mentioned that to neuro only the other day'...... I was sitting in the car and everytime I put my head down I felt like someone was pouring hot water down my leg.....wondered what that was is it a common one?

Glad I found this place (well not but you know what I mean none of us are!) Its good to get advice of others going throught the same thing......so Thanks everyone for your help and sure I'll  have plenty more questions.

 

L'Hermitte's sign describes electrical buzzing sensations in the limbs and body brought on by movement of the neck. These sensations are known as paraesthesia and include tingling, buzzing, electrical shocks, partial numbness and sharp pains. L'Hermitte's is most often triggered by lowering the head so that the chin touches the chest. The sensations usually only last for a second or two. It has been called the "barber shop" symptom because it is often evoked when the hairdresser asks you to lower your head when he or she shaves the back of your neck.

L'Hermitte's is associated with a number of conditions including arthritis, cervical spondylosis, disc compression, pernicious anaemia, tumours and multiple sclerosis. In many cases, the cause cannot be found.

Because the cervical spinal cord is a frequent target for multiple sclerosis it is a very common symptom of MS. Aproximately two thirds of people with multiple sclerosis experience L'Hermitte's symptom at some point during thecourse of their disease.

In MS, L'Hermitte's is an indicator of lesions in the cervical spine (the part of spine in the neck). Movement of the neck causes the damaged nerves (the demyelinated neurons) to be stretched and send erroneous signals. The symptoms can occur anywhere below the neck and many people with MS find that it moves around their body from one day to the next.

 

George