Forum

neurology appointment

my neurology appointment is coming up next week. i was wondering what happens if all the neurological tests done on the day for balance etcshow no abnormalities will the neurologist still order an mri or other tests. would love to hear of everyones experiences with their first neurology appointment. i am going through a good spell at the moment and dont know whether thats a good or bad things with this long awaited appointment nearly here. x

Hi Serina, I would be interested to know the same. My appointment is not for nearly three weeks and I am slightly worried about what might happen during the appointment.

Also what do you wear to see the neurologist? Will we be needing to get our kit off at some point? (oooooerrrrr)

I think it also depends on history as to whether they order an mri with a normal neuro exam. Re what to wear I chose leggings as they lift your legs up and test strength so didn’t want to flash pants but as I thought he may need to do knee reflexes leggings could be pulled up easily where as jeans couldn’t A xx

Serina, I’ve thought the same thing about seeing a neuro on a ‘good day’. I haven’t even got my date through yet. I’m just trusting that the neurologist will see what they need to see. (Vis a vis Number08’s point about what to wear :wink: Arwen - good suggestion, thanks.

i hadnt even thought about what to wear lol but leggings sound a good idea. ive had such a bad year and had a couple of good spells before but i really hope that im taken seriously, i start to doubt even myself when im feeling as i do now but i felt like this before and doubts all disappeared when symptoms came back. i dont know if anything will flag up with neurologists tests but i really hope he doesnt tell me to wait and see if they are ok without asking for an mri. ill be so fed up x

Firstly,- I am really sorry, cos I don’t want to start with negatives, but I think people in your situation need to be prepared as much as possible. I think that one thing that shocked me with my first appointment was how short it was — it is not uncommon for an initial appointment to last only around 9 minutes, which is maybe not as long as patients feel they they need in order to discuss problems & concerns properly, especially if you’ve been waiting months to see someone. But I think if you go in knowing that the appointment might be rather brief , it is probably easier to deal with if it does happen.

Secondly - again some negative news, but also positive news too - some neuros can be less than helpful, BUT others are brilliantly helpful and supportive. It can be a bit pot-luck.

They should start the appointment by taking a history. Some doctors are good at this, others not so good. they will possibly ask things like -history of similar conditions in family - any medications you are taking - any other health conditions you have. Then they will ask about the health problems that prompted your refral. It is sometimes helpful at this point if you take with you a symptom list (there are some v good threads on this forum explaing how to do these well)

Then they may do physical exams. They may check reflexes, balance, coordination, skin sensitivity. But, not all neuros do all of these tests for all patients. I was really surprised in my first appointment, as I had expected balance / coordination tests (Id read info about what to expect) - but actually all my neuro did was a 3 minute test where he checked my reflxes by tapping various parts of my legs (knees, ankles etc). I am not sure why some doctors to more comprehensive tests than others… it may be down to time constraints, hospital policy, or even the consultants decision as to which tests are apprpriate for a particular patient, I don’t really know!. So in a way, expect the unexpected… none of the tests are painful, so there’s nothing to worry about… but you might not get all the tests you may have read about (although then again, you might!) Its a sort of ‘wait and see how it pans out’ situation… but the main thing is, none of the physical exam tests are painful at all.

I’m not sure about your question as to whether neurologists will order MRI if physical exam was fine. I think (but am not totally sure) that MRIs are ordered quite commonly after most first appointments. And even if your neurologist wasnt immediately convinced an MRI was needed, you would be within your rights to point out that signs of MS do not always show up on physical exam and ask for an MRI for on those grounds. I guess there might be cases when they stand by the decision that an MRI is not necessary - but you would be completely within your rights to ask for second opinion if that happened.

With regards to clothes… In my experience (others correct me if I’m wrong) I didnt need to remove clothes for physical exam. But the reflex exam did require me to bend / move my legs a bit, so I would make sure you’re wearing something comfortable - maybe nothing too tight to restrict movement. If you are concerned, ring the dpt the day before and check if they have any guidelines for clothing.

My final pieces of advice.

If you can, take smeone along to the appointment with you. It is a daunting experience, & good to have support. Sometimes in stressful situations it is difficult to take in all the information - it is handy to have someone else there.

Good Luck with it all… it sounds more daunting than it actually is! x

Hi Serina

I want to echo some of Anons fabulous post.

The appointment can be very quick. I was allocated 20 mins. I actually took 35 and even that felt rushed (not to the point where I couldn’t get anything across though) Aware of the appointment times, I prepared my symptom list in order of what was currently bothering me and what had ‘resolved’ to some extent. I had 5 symptoms on the troublesome list and 5 on the ‘resolved’ list. As it was, I managed to get out 9 in total over the appointment.

I had a lovely neuro, but have in the past had specialists who are complete arses. Pot luck I guess.

My neuro took no history. Which as I had spent ages quizzing my relatives on their various auto immune illnesses, annoyed me a little.

I also had a very basic neuro exam where he tested my reflexes. Had he tested my balance, I am sure he would have found it very interesting, but hey ho, we can’t expect them to do everything…

I wore light trousers and these seemed to be fine

Also can’t comment on whether or not he will order an MRI. He did in my case as I have Trigeminal Neuralgia and Optic nerve issues. Sorry.

Will also echo about taking another person with you. My hubby came and he did remind me of things that i had glossed over/forgotten. Also, prepare your symptom list. It will come in very handy.

Best of luck.

Angelax

Thank you both very much for the advice and info. Its very useful to know the negatives as well . It helps to know what to expect. My Gp when referring asked to keep my symptom list in order to do the referral so neuro should have details but i will do another one as new symptoms have arisen since then. I dont want to sound like a hypochondriac and from reading other posts it would seem its better to have a short list of main problems.

thanks again for brilliant advise x

Hi Serina

My review with both MS specialists was v thorough I had 1 hour for history and neuro examination. The general neuro I saw however only spent 15 mins with me - but he did refer me on to the second MS specialist (my first MS specialist was terrible - it was his registrar who tested me on the first visit so I went for a second opinion).

Go prepared as the others have said with a brief timescale of symptoms (keep only to the pertinent symptoms that have occured). Write a list of current symptoms bothering you (max 5 in order of most important first). Make sure you have notes on any other relevant general helth/ family history issues. Most importantly don’t selfdiagnose. This always sends warning bells in the doctors mind that you have been googling and convinced yourself you have MS.

Pending your symptoms and assessment the neurologist will hopefully decide to send you for further tests - this could range from something as simple as bloods / EMG’s / lumber puncture to MRI. Most importantly keep an open mind - there are many conditions that can mimic symptoms of MS.

Good luck

Reemz

X

Thanks Reemz, after 10 months of knowing something is wrong a hospital appointment has suddenly become. the most important thing in my life, im going to have to try and calm down or neuro will think its all caused by stress. Maybe it is… not sure if optic neuritis and numbness can be stress related tho x

My neuro just asked me to take my boots and socks off so I was barefoot for some of the balance stuff. I can’t offer advice on the rest of the stuff as I’d alredy had a spinal MRI, that’s why I was referred and the neuro already thought it was MS before meeting me ouch Good luck, Sonia x