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leter from Nuro - please explain

Hello everyone,

Ok So I recieved a letter from my last visit and I have a new appointment booked in for the 23rd of May.

Her Diagnosis so far, is 1. Mild Inflammatory Central nervous system episode. 2. Stress related symptoms.

I wont bore you with the whole letter which overviews what we discussed but here are some things I am confused about.

I have Left ptosis but no pupillary abnormaility.

Reflexes are reduced

No great toe movement for left or right plantar but toe splayed upwards.

Variable pinprick changes over my legs

Scan unchanged and blood all fine.

Now if my toes splay upwards this indicated a problem with the spine does it not? Does this not indicate they should re do the spine scan that was blury both times I had one before and maybe could end all this for me now?

The stress related was being in a stroke ward at 27 years old for 1 week and then 2 weeks, I would say that would be normal wouldnt it?

If it was a mild episode, why has it lasted for 9 months and still continuing?

I suppose on my next appointment I will be booked in maybe for a spine scan or something at least but its confusins and the only thing signifacnt really is about the toes as before they said one went down one didnt move now she is saying they both dont move but they do spray up ahhh so confusing. Any advice would be apreciated please

I have Left ptosis but no pupillary abnormaility. This means that your left eyelid droops, but that your pupils respond properly.

Reflexes are reduced. This means that your reflexes are less than would be expected, i.e. there is a smaller and/or slower movement.

No great toe movement for left or right plantar but toe splayed upwards. This means that you had a positive plantar, although the movement wasn’t big. A positive plantar (and reduced reflexes) suggests a problem with the upper motor neuron, the pathway between the brain and the muscles that tells the muscles when to relax.

Variable pinprick changes over my legs. This means that there are sensory changes in your legs.

Overall, it’s an abnormal exam. I would think (and please remember that I’m not a neuro) that a decent spinal MRI is important, but without new symptoms, the neuro may think it’s not essential. At the moment, and with only the one attack, I would think that an inflammatory CNS episode is a sensible diagnosis and having any lesions on your spinal MRI wouldn’t really change that.

I would think she’s saying mild because you haven’t been left in a very disabled state (e.g. in a wheelchair). Unfortunately, even relatively mild attacks can leave permanent symptoms, but there is a chance that yours will still improve.

I think, if I were you, I would suggest another try at a spinal MRI, if only for a decent baseline in the event of new symptoms.

Karen x

Sorry about the formatting on that - there’s a glitch when you copy and paste from someone else’s post and I couldn’t be bothered retyping what you’d written!

Kx

No thats fine, Thanks Karren,

My left eyebrow doesnt lift properly and if it does it drops straight away.

I was in a wheelchair in hospital and now I can get about with a walking stick but could prbably really use one if we go out anywhere which means I have to walk for any distance or stand for a time, I cant do either of these.

I know what your saying is right and she may suggest another spine MRI, by new symptoms your right just the old ones but I would hate for something terrible to have to happen before they do something about it. I suppose I can tell her about my Virtigo ive been having, the pills stopped it but now im off them it is back mildly but not enough to warrent returning and telling my doc.

Has anyone mentioned MG…just the drooping eyelids rang a bell?!

No noones mentioned MG, I will have a look but wont listen to doctor google too much.

My left eyelid is a bit droopy but I cant raise my left eyebrow without it dropping it will go up and back down weird.