Just looking advice

Hi, I recently had a full spine MRI based on a neuro exam that showed different positive reflexes.
Babinski
Hoffmann
Exaggerated deep tendon reflexes.
All bilaterally.

My MRI has came back clear apart from showing age related wear and tear.

I got a bit flustered in review and didnt ask about why reflexes would have shown up in the 1st place, i was originally seen due to experiencing tingling and to be honest i didnt even realise i was being tested for reflexes, i had just followed what he asked.

Suppose its important to note that the consultant didn’t mention them either at all just said all good, now go away and lose weight. I was barely in 10mins.

I asked him about pain im experiencing, he said due to weight. I told him i have tingling, pins and needles in my feet, didnt answer. I have what feels like numbness in my lower leg.
I also have constant muscle twitching, i can sit and watch my leg muscle popping about.

I have requested a copy of my mri and report, though they said it would be up to imaging but I’ll keeo insisting.

Basically what i am asking i suppose is should i persue answers about reflexes, be that from him at another appointment or a second opinion. I know spines can be clear but brains affected. Or can you naturally have reflexes like that and if consultant was suspicious he would have ordered more tests.

Any advice appreciated :pray:

It makes me cross when people present with neurological symptoms and are told to lose weight. Talk about exaggerated reflexes: that seems to be an exaggerated reflex in most doctors - they really ought to get it seen to if you ask me!

I do not know the answer to your questions. How was it left? That you would be discharged? That they would wait and see if something else came up? Watchful waiting is a very common approach with these things, so don’t be too surprised or disappointed if that is what is suggested, but you do need to be clear about what has been suggested. And it isn’t the end of the world if that happens - most things get easier to diagnose as time fills in more pieces of the puzzle.

I was misdiagnosed for many years with spinal stenosis and have numerous spinal MRI’s. At no point did anyone have a light-bulb moment and think “maybe we should scan your head as well”.

So my advice is to get your head scanned.

It is possible to get MS without any brain lesions, but it’s pretty rare and clearly your spinal MRI’s aren’t showing any. In my case, an osteopath took one look at my walking gait and sent me back to Neuro. I got an MRI within a week.

By the time I was seen by the Osteopath, I was well overweight but at the time of MS first instance (in hindsight), I was fit, muscular and quite slim. Kept telling them that weight wasn’t the cause though it’s true that excess weight can amplify symptoms.
Graeme

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I should also add, its a very odd set up, I had absolutely zero idea what a neuro exam was, the heel toe walking etc i just did what was asked.
Even at that point he was extremely tight lipped. Said I’ll go ahead and order an mri so i assumed it was normal procedure.

A week or so later i got a letter id been CC into that had been sent to GP. It was that letter was the 1st I knew about the reflexes showing up.
It was only at that point i looked them up, all indicators of UMN. I think the hoffman can be anxiety related too but all 3? I find hard to believe all are anxiety related.

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When i seen the neuro for my review of the mri results (only 2nd time id seen him, 1st time was when the reflexes showed up hence mri)

He literally said I havent seen your file, so uploaded it and showed me the 3 sections of my spine, cervical and lumbar have ‘wear and tear’ he then took a min to read the radiologists report on screen to see if it matched what he was seeing. Said your spine has aged but with weightloss and some physio that should help. All the best :+1:
No mention of why I would have 3 different reflexes show up. My fault too for not asking.
I thought he was looking for lesions
No mention of whether gp will receive a report
If i will receive a report
If he will request physio via gp
If ive to organise it.
It was literally just goodbye.

If feel so disappointed, he is one of the top consultants in our area, I must be clear, I :100: do not want or wish to have an illness but id like a proper review.
I would have to pay private to see him again as I was NHS.

Maybe a website of my friend might be helpful https://multiplesclerosis.healthytreatment.org/

Hi Shoegal, I don’t have any advice but wanted to say I’m in a similar situation. I first presented with tingling (my entire left side) so GP was worried about stroke and sent me to A&E. I saw a neurology registrar who did some reflex tests and ordered a CT scan (which was clear) and then an MRI (found a 10mm lesion). It wasn’t until I received a letter to my GP that I’d been CC’d into that I found out I had brisk reflexes and positive Hoffman sign. Why didn’t he tell me right there and then?! He acted as if everything was ‘normal’. I totally get your frustration on this. I’ve since had a more detailed MRI on brain and found a couple more lesions. Also a spine MRI which the results are back for but I can’t access them until that original bloody registrar gets off his arse and writes me a letter. It’s been 2 months since I first presented and I haven’t had an appointment with anyone to discuss anything. I guess I’m a bit behind you in waiting for a proper neurology appointment. I hope I can ask all the right questions. Definitely think you could call the secretary and ask for a follow up appointment as you have more questions than answers. Good luck!

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That is so similar, makes you wonder why they dont say anything about reflexes or their next steps, maybe its not to worry us, yet getting copied in a letter is worse!

I havent been back, I took the word of the neurologist and took some time out.
I continue to have symptoms, constant vibrating/buzzing in my legs, still constant muscle twitching, pins and needles.
Bouts of extreme fatigue, about 3 weeks ago i could barely function, I slept for hours upon hours without any sign of feeling refreshed.

Re the reflexes, one of mine the plantar possibly showed up as there is a slight disc bugle in my l5, however this is the same bulge that didnt get a mention in the review letter to my gp, so minor not worth mentioning, so minor couldn’t be causing buzzing legs, so what is?

The hoffman and brisk can be present in those with anxiety, hence why i took time away incase it was just that.
Would you consider yourself an anxious person just out of curiosity?

I went back to my gp regarding the muscle twitching and buzzing and was told on the spot of benign fasciculation and the buzzing well who knows, just one of those things!
They kept insisting my mri was clear, so nothing to worry about, so i said what Greame had said. No one has checked my head-the reply was why would they need too?? Your mri was clear :woman_facepalming: ive also had physio since and had my reflexes checked only the hammer on knee one, wow my goodness very brisk was the response-but that can be normal for some people.
I give up!
Ive since read too that fasciculation syndrome should only be diagnosed once everything else has been ruled out, not in a 3min appointment.

Thats positive news for you that you have had a couple of mris, although you are in limbo, the fact some lesions have been seen is enough to prompt further investigations.
Please keep me posted as i am very interested given we have the same reflexes.
Hope you’re not waiting too long! Good luck :four_leaf_clover: