Neuro explanations ?

I was diagnosed with RRMS last week and have received letter from Neuro confirming RR.

Could someone help explain the results to me please.

Fundi normal no evidence of papilloedema

Extraocular movements normal with no nystagmas,diplopia or INO

No evidence of scotoma

No dyschromatopsia or RAPD

Cranial nerves intact

Cerebellar intention tremor on left.

Increased tone left lower limb and both upper limbs.

Normal in right lower limb.

No clonus

Power at finger extension on left 4+ hip flexion on left 4 and on the right 4 +

Other wise power 5 through out limbs

Brisk reflexes upper limbs and knees

Hoffmans negative

Ankles normal

Plantars mute bilaterally

Rombergs negative



Sorry, Yvonne, haven’t a clue about most of it.

He sends this drivel out - get him to explain it! In my view, this is medical talk between professionals, and goes into a level of detail most patients neither want nor need to know. The key finding for you is that you’ve been diagnosed with RRMS.

An unintended consequence of the drive towards greater patient “transparency” is that many patients are now bombarded with information a layperson can’t understand. My guess is this report wasn’t addressed to you, but probably your GP, or even a fellow neurologist. You’ve been copied as a “courtesy”, but all it does is muddy the waters.

If he’s going to send it out, he should provide the translation as well. Sorry - I’m not cross with you, I’m cross with him.

Too many examples of patients receiving this gobbledygook, and fellow MSers then struggling to decipher it.

I know what a few of the terms mean, but not all, and to be honest, I’m unwilling to do his job for him. It would take me all afternoon to go through it point-by-point, and explain what I know, and Google all the bits I don’t.

You could book an appointment with your GP, who would probably be able to translate most of it for you.


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Tina is right. This is really a report to your GP.
Some bits can be extracted, but without any detail:

The first four items are about your eyes - all looks normal.
Your reactions look normal.
What you need a professional - like the guy who wrote it it - to explain is the limb movement stuff.
I would be guessing that you are starting to have a wee bit of restricted movement in your left leg.
This could (like could) suggest that somewhere down the line you might just have have restricted movement or even a drop foot.
The cerebellar tremor is what most people call an intention tremor, you move a limb and it goes of in a slightly different direction. This is more like something you have to watch out for, and then work out a coping strategy. I have this problem with my left hand/arm. I have to cut my food up into small chunks and use a fork in my right hand, American style. This way I do not get a hot piece of bacon up my nose, or in my ear.

What you should do:
If you drive, notify the DVLA (legal requirement) and your insurance company (it is a “significant change” under most contracts).
If you do not drive an automatic car, you need to be thinking about one now (not in some years time when you can no longer use the clutch pedal). I was lucky in that I had driven autos for years before my MS even started. This does meant that you should get a proper explanation of all the bits in the report that relate to left leg function. If it is the right leg that is potentially a problem, this could mean hand controls - using these is something that you can try out if you have a car with cruise control.

Hope this helps you.


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It was sent to me and the GP.

My actual symptoms are the left hand tremor and some problems with left leg including a degree of drop foot.

I will contact GP shortly and ask her.

I do not actually drive so have no issue there.


Was the letter addressed to you, copied to the GP? Or was it addressed to the GP, copied to you?

If it was addressed to you (copy to GP), I think your neurologist needs a ticking off for writing to a civilian in ‘doctor-to-doctor’ shorthand. If the letter was addressed to the GP (copy to you), then I have no quarrel with it - I ask to be copied in on GP letters too, just for info, but I don’t expect to understand them if they get technical because they’re not really for me.

There’s nothing wrong with technical shorthand between professionals, but there is a lot wrong with it when used lazily to bamboozle a normal person.

I am sorry to learn of your dx. Try not to fret too much about the terms in the letter. Many of us (me included) have just got on with having MS for years and years without having the slightest idea about all that. Not worth bothering over.



Hi I just checked it was addressed to GP with copy to me.I am naturally curious and a bit anal about understanding things.

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and this is absolutely THE best way to be!