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Thread: Sorry to bother you all again...At what point should sensory test be done

  1. #11
    Senior Member jccarolina's Avatar
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    Quote Originally Posted by uuudianauuu
    Neurologist won't give son sensory test! He asked why I wanted it, I told him because it would be nice to know exactly what was gone and because I am his mom and want to know.
    What a butthead. That was one of the first things mt neuro did when I first saw him. He had a full EMG done including the needle test.
    If the Army & the Navy ever look on heavens scenes, they will see the streets are guarded by United States Marines!


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  2. #12
    Neurologist was a real gem. I have learned more from this site, than he cared to explain. He always got mad (annoyed looks) if we asked questions.
    He also never asked sons symptoms, only wanted to look at mri readings. We tried many times to tell him symptoms, he would not listen. I will take son to new neurologist, I like ortho, but he doesn't treat backs.
    All the information I gather here wil be taken to new doc. Son still hasn't had complete sensory test. Orthopedic doc did offer to have one, I think it was something to do with needles and electricity. I will have son do this test. Son said no-way,when he said needles. I will take him anyway...
    Thank-you,
    Diana

  3. #13
    Banned adi chicago's Avatar
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    needles and a comuter can meausre a lot .the docs did it on me in china after the oeg procedure .in usa no doc did the same .i wonder why?
    asia score maybe?
    • Dum spiro, spero.
      • Translation: "As long as I breathe, I hope."

  4. #14
    My son was at a level 3 trauma center. No asia scale ever done. His care was turned over to a general surgeon in emergency room ( notes say because er was extremely busy) I had argument with Doctor about son not seeing neurologist or orthopedic doctor on day 3 of his stay. I had to fight for thoracic mri.
    I did not know, all that I have learned from this site then. After son came home I started researching. I am amazed at how I have to push for information from his doctors. Its been 3 months, its getting exhausting trying to have test done. I can see why people just accept what ever the docs. say.
    Did you learn anything more from your test in China?
    Thank-you,
    Diana
    Last edited by uuudianauuu; 09-07-2007 at 10:03 PM.

  5. #15
    Banned adi chicago's Avatar
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    Quote Originally Posted by uuudianauuu
    My son was at a level 3 trauma center. No asia scale ever done. His care was turned over to a general surgeon in emergency room ( notes say because er was extremely busy) I had argument with Doctor about son not seeing neurologist or orthopedic doctor on day 3 of his stay. I had to fight for thoracic mri.
    I did not know, all that I have learned from this site then. After son came home I started researching. I am amazed at how I have to push for information from his doctors. Its been 3 months, its getting exhausting trying to have test done. I can see why people just accept what ever the docs. say.
    Did you learn anything more from your test in China?
    Thank-you,
    Diana
    i learned a lot of things about sci ....in usa they never used needels and a computer to check what is all about regarding my asia score .
    • Dum spiro, spero.
      • Translation: "As long as I breathe, I hope."

  6. #16
    jccarolina,
    I was searching through your post, trying to find out about your cauda equina injury. I think my sons injury is most likely periphial nerve damage.
    I'm not sure, exactly. I am trying to find out...
    Can I ask how you arrived at your diagnosis? Did you have mri? Did sensory test show this?
    Thank-you,
    Diana

  7. #17
    Senior Member jccarolina's Avatar
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    Quote Originally Posted by uuudianauuu
    jccarolina,
    I was searching through your post, trying to find out about your Cauda Equina injury. I think my sons injury is most likely peripheral nerve damage.
    I'm not sure, exactly. I am trying to find out...
    Can I ask how you arrived at your diagnosis? Did you have MRI? Did sensory test show this?
    Thank-you,
    Diana
    I had both. The MRI was first about 4 years ago. It showed the fracture to my coccyx, sacrum and the L4-S1 vertebra. along with the severe loss of disk space.
    The doc back then gave me a Dx of Lumbosacral Sensory Radiculopathy (severly limited).

    I had my Electromyography a year or so ago with my new doc, and thats when he changed my Dx to Cauda Equina injury.
    That, and the symptoms I presented were equal to Cauda Equina Syndrome.

    He said in "laymens terms", there was very little communication between {L3 now} and my feet,
    (the dammage has progressed. )
    Last edited by jccarolina; 09-08-2007 at 02:00 AM. Reason: added links
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  8. #18
    Technically, the cauda equina is made up of peripheral nerves, even though they are still inside the spinal canal. As soon as the nerves leave the spinal cord, they become peripheral.

    I hope you followed up with a complaint to the "level 3" trauma center (which is not as advanced as Level I or II). Did you ever see an attorney about this?

    (KLD)

  9. #19
    Hi,
    I have not followed up with complaint, but will as soon as I know exactly whats wrong...I'm still lost about this. As for attorney, no. I don't see any reason, that I'm aware of at this time, to get one. My son did this to himself. What grounds for this would I have, am I missing something?
    At hospital he was givin full body ct and xrays, at time thoracic 7, 20% compression was only thing that showed up. Images at hospital were very poor quality.
    As for doctor who treated him, Im not to happy with him. My son actually lost sensation in right two toes infront of me, it happened on day 3 of hospital stay, during an episode I believe now was Autonomic dysreflexia. He had not urinated in 3 days...this was brought up to doctor many times prior, who said, there is probably swelling which will resolve itself.He had a very bad headache, got really dizzy and nauseated, goosebumps etc. Then he said he felt weird..my toes feel weird, woe this is strange etc. Nurse was concerned, they did ultra sound on urine I believe it was 425. They told him they were going to have to catherize. He shortly after urinated. I'm pretty sure he stimulated or pressed to do this. He did not want to be catherized.
    I asked Doctor about toes and numbness in buttocks, and again was told he crashed his motorcycle, its going to be numb. As for his back, he was in major pain. I had to push for mri, of this area.
    Doctor was not great....
    I wish I had known more about hospital levels etc. I would have had more of the right test done already...3 months since accident, and we are finally going to get sensory test.

    Ok, this makes since about peripheral nerves.
    Do they show up well on the Lumbar mri images, I mentioned?
    If you have peripheral nerve damage..is this neurological?

    (The reason I'm asking, is I'm wondering why sons Nuerologist did not mention peripheral nerves...Is he best suited to diagnos this? Not that we are staying with him, just wondering where to go next, Ortho will refer us to someone in San Diego.)
    You mentioned a physiatrist... I had never heard of one before this. I found one for son, and have an appointment this wednesday. He doesn't usually treat anyone under 18, but has agreed to see my son. I'm not sure exactly what he does.
    I'm not sure who my son should be seeing... I really just want to know what is lost, and whats causing it. This is so frustrating! I'm sure alot of this goes back to inadequate hospital and doctor.

    Thank-you, Diana
    Last edited by uuudianauuu; 09-08-2007 at 02:01 PM.

  10. #20
    Quote Originally Posted by uuudianauuu
    Thank-you,
    I have called doctor to clarify this. He is out of town until Tuesday, and will return my call then.

    Peripheral nerve damage makes alot of sense. This is most likely reason for his symptoms.
    I was reading about this in some of your post, this led me again...to Cauda Equina and Conus injuries. Sons symptoms are primarily unilateral ( right side), so I am assuming Conus is not his injury. Cauda Equina symptoms are really close to my sons. He has the saddle anesthisia, sensory loss on right side is S1 nerve sensory area. The only thing I am unsure of is bladder. He only feels this when it is full or near full, and goes alot. I haven't been givin explanation for this by doctors.
    Questions;
    Can peripheral nerve damage mimic that of Cauda Equina injury?

    Is one mri taken one month, after motorcycle crash, sagittal t1 and t2 lumbar, and axial t2 lumbar
    (without dye) acceptable in ruling out Cauda Equina injury?

    How well does the Cauda Equina show up on these types of images.

    Thank-you, many times over!!!
    Diana
    Diana,

    The diagnosis of a cauda equina syndrome, as I think that you now realize, is primarily by neurological examination. I am very impressed. The fact that your son's symptoms are mostly on one side would tend to argue against a conus injury and would support a cauda equina. It takes a very experienced neuroradiologist to assess cauda equina injuries and particularly to assess the which roots are affected. Even in the operating room, when one can see more of where things are coming from and going to, it is often confusing. Some surgeons would use electrophysiology to confirm the identify of the spinal root that they are working on. It is sort of like operating on a bunch of spheghetti.

    Physiatrists are trained to work in teams of physical, occupational, and other rehabilitation therapists who address the different needs of people with spinal cord injury. They usually do their residencies in large rehabilitation hospitals where they do see a lot of people with spinal cord injury, stroke, traumatic brain injury, and other neurological disorders. While they are very good at examining and documenting spinal cord injury, they tend not to be experts on the neurological examination of the cauda equina. On the other hand, they ware really the only people who know about urinary problems, pressure sores, bowel routines, spasticity, autonomic dysreflexia, spasticity, and neuropathic pain because they see these problems all the time.

    As it turns out, because they end up seeing the most people with cauda equina, orthopedic surgeons are often the ones that now the most about cauda equina. This is because any damage to the spine from L1 to S5 can involve the cauda equina and those cases go mostly to orthopedic surgeons. So, for example, the emedicine article on cauda equina syndrome was written by orthopedic surgeons (Source). Actually, in my opinion, it is the patients who know more about cauda equina than anybody else, more than the doctors. There are a number of really good cauda equina support groups (Soruce).

    Wise.

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