Neuro examinations

I’ve had 4 neurologist examinations now, and each time with a different neuro. I’ve notived they all do a different variation of tests within the examination. One examination I think is fairly interesting is for clonus. The last neurologist didn’t tell me to relax and I was sitting with my legs over the side of the couch, so he was tapping my knees to see a reaction in my legs but it was varied - well it would be if sometimes my legs were not relaxed. All the neurologists i’ve seen have assumed I have been completely relaxed when these tests are being done, but they haven’t actually told me to relax at any point during my appointment.

I’ve been watching a few medical school neurologist examination vidoes on Youtube (Manchester Uni and Leicester Uni). The neurologist in the video states the patient much be completely relaxed and not focusing on the clonus examination. Its been good for me to watch these to understand it all a bit more. Sometimes I’ve had an examination before and the neurologist hasn’t said anything about if my examination was normal or not. Its only until I get a letter a few weeks later from them I find out.

Hi Helebon,

Self education about MS is a good thing, but I’m really not sure mulling over and comparing every neuro examination you’ve ever had is quite so positive. Of course different neuros have slight differences in practice - they’re people, not machines, and will develop their own individual styles.

I’m really not sure what point you’re making. Do you feel some of your neuro examinations weren’t valid, because they weren’t done properly?

Are you still questioning your diagnosis?

It’s really not that easy for a neuro examination to give “wrong” results - they are notoriously hard to fake, even for a patient who was actively trying to - let alone just because a patient didn’t quite relax enough. And even if one, or perhaps two of your examinations had been flawed or inadequate, don’t you think having four would have uncovered that? Not to mention the additional evidence that has led to your diagnosis.

At the point you are now, I would say how good or bad past neuro exams have been has become largely irrelevant. They were obviously sufficient to get you referred for further investigation - which is the key thing - and that investigation has revealed MS.

You got diagnosed - albeit perhaps with hiccups on the way - but what is the profit in going over old ground? I can think of many things that were done wrong in the course of my journey to discovering I had MS. I have been told ridiculous things over the years, such as that my problems were due to one leg being longer than the other, or to the shoes I wear (I’ve never worn extreme shoes, much as I’d like to).

But all that is water under the bridge now. I did get diagnosed in the end, despite some crazily misguided theories by people who, with hindsight, had absolutely no idea! I don’t find it fruitful to dwell on it that this person or that person probably should have done a better examination, or should have spotted things they didn’t. It’s not really their fault that, when I was complaining of painful legs and feet, nobody thought to scan my HEAD! It was easier to say: “Don’t wear silly shoes!”, and blame it all on that. But it’s all in the past now.

Tina

x

Tina, Thanks but you seem to have misunderstood my thread. I am not blaming any neurologist or saying they got something wrong, what I was expressing was that it would have been good for me to know to relax for the examination. Now I know to relax when I have these examinations that can only be a good thing. I think you may have read too much into my thread Tina. Perhaps these online forums are not right for me anymore, a GP has mention to be open minded about what people say on these forums. I guess things can be easily misinterpreted.

All the best

But, with respect, perhaps you have not understood my answer either?

The point I was trying to make was: “Does it really matter now?”

You still got diagnosed anyway. Whether you were told/not told to relax, it doesn’t appear to have done any harm. And I have only had one neurological examination post diagnosis, three years ago (which is fine, as I hate them). So they are really used mostly as a diagnostic tool, and it’s not something you can expect to face all the time.

OK, so you will know to relax next time. But there might not even be a next time - or not for a very long time.

Tina

Hi Helebon. I remember at mine my neuro did tell me to relax which was good because for some tests I wasn’t sure if I was supposed to be moving my legs for him etc. Axx

Some neurologists are better than others at relating to their patients.

The last one I saw was really nice and had a very gentle manner. This suited me because I don’t respond well to the more bossy, cold types.

Take care, Helebon