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Thread: why would the neurologist ask me this?

  1. #1
    Moderator jody's Avatar
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    why would the neurologist ask me this?

    He asked me if I took hot baths.

    I said yes, it sometimes helps if the stabbies bad, or when the burning is bad. .... or if I have been out in the cold and cant warm up.

    he said do you get weak and have to get out before you pass out?

    yes.

    every time?

    no, as soon as I feel that feeling, it I get out.
    so you get it every time?

    I guess.

    are you wiped out after a hot bath?

    yes, I usually lay down a few minutes after a bath.

    is you heart beating hard, and then slows when you get out?

    yes.

    anyone know why he would ask me that, and why it is spot on?

    I just figure I overheat easily and get cold easily.

  2. #2
    Weakness and temporary worsening of symptoms after a hot bath (known as Uhthoff's phenomenon) were major criteria in the diagnosis of MS prior to the advent of MRI and analysis of cerebrospinal fluid. Uhthoff's phenomenon is not specific to MS and is a feature of other neurological conditions (particularly those involving demyelination), but it tends to be universally present in MS. Your neurologist is very thorough; including this question in his workup will help him to form a finely drawn picture of your condition.
    Last edited by Bonnette; 04-01-2011 at 06:52 PM. Reason: spelling

  3. #3
    Quote Originally Posted by Bonnette View Post
    Weakness and temporary worsening of symptoms after a hot bath (known as Uthoff's phenomenon) were major criteria in the diagnosis of MS prior to the advent of MRI and analysis of cerebrospinal fluid. Uthoff's phenomenon is not specific to MS and is a feature of other neurological conditions, but it tends to be universally present in MS. Your neurologist is very thorough; including this question in his workup will help him to form a finely drawn picture of your condition.
    Jesus. That's terrifying...

  4. #4
    McLovin, it's pretty typical of SCI - whether atraumatic or traumatic - for heat to cause temporary weakness and transient worsening of symptoms. It's just the nature of the beast. Neurologists usually ask patients about their reactions to heat as part of the diagnostic workup. Neurological conditions are so complex and difficult to diagnose that the more questions asked, the more precise the doctor's assessment is likely to be. MS patients usually report Uhthoff-type symptoms, but Uhthoff's phenomenon on its own does not mean a person has MS; it's just one piece of the puzzle, and it used to be a more significant finding than it is today (since the advent of imaging tests that can actually reveal lesions in the brain and cord).

    Here's a link to an informative site where Uhtoff's phenomenon is discussed.
    Last edited by Bonnette; 04-01-2011 at 07:54 PM. Reason: addition of link

  5. #5
    Moderator jody's Avatar
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    Iv been asked about heat and cold, but this is the first time ive been asked that.
    holy cow.

  6. #6
    Moderator jody's Avatar
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    I see he has ordered a lumbar puncture.
    Id do that over an emg, but hell that sucks.

  7. #7
    I prefer a EMG. I never want to take a lumbar puncture again.
    TH 12, 43 years post

  8. #8
    Jody, from your public profile I gather that your SCI is injury-related; does the neurologist suspect that you have a new or different neurological issue at this time? If so, a lumbar puncture could be a big help in tilting the scales one way or another (diagnostically). As I understand it, EMG is a somewhat subjective test, in that its assessment relies heavily on interpretation of the results; the outcome of a lumbar puncture is graded on objective scales employed by particular laboratories.

    EMG and lumbar puncture are unpleasant procedures, that's for sure - but sometimes it's worth the discomfort to have answers. I don't know what prompted the in-depth neurological workup you're going through, but I hope that in the end it will help you to find the treatment and followup that you need.

  9. #9
    Moderator jody's Avatar
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    what is
    CPK/anti-DS DNA AB
    ACElevel
    RpR
    CNNCA
    P ANCA
    L anticoagulant
    v58.69
    and the rest is about 15 sets of numbers in the 770.'s and 780. with various numbers behind the decimal point.

  10. #10
    CPK = creatine (not creatinine) phosphokinase

    ACE = angiotensin-converting enzyme

    p-ANCA = antineutrophil cytoplasmic antibodies

    RPR - rapid plasma reagin

    Don't know what the others are, but the ones above are intended to rule out (or in) particular conditions, to assess cellular properties, and to check for specific antibodies or exposures to disease.

    I wish I had your neuro, he's asking the right questions!
    Last edited by Bonnette; 04-01-2011 at 08:23 PM. Reason: wording

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