Tag Archives: Neurological Exam

What to expect at the Neurologist’s office

Or what to expect when you’re neurologing.

I have two neurologists and their styles are very different.  For this article I will focus on my first, the subject of my prior post that we will call Dr Fundamental.  We will get to the second one shortly.

Dr Fundamental’s routine is typical from what I have experienced with other appointments.  If you have apprehension about seeing a neurologist, relax.  It’s not painful nor do you have to work hard such as you might at a stress test.  The beginning of the appointment was just a conversation.  Doc F asked me many questions about my experience and history and took copious notes.  Being old school, his office was lined with bookshelves that must have had a thousand books on them.  No doubt, he has read them all.

We then started a physical symptom check.

Stand up please.  Stand still with your eyes closed.  Touch your nose.  Walk down the hallway.  Now walk back.  Walk on your toes.  Walk on your heels.  Walk heel to toe, heel to toe.  Alternating hands, touch your nose as fast as you can.  Squeeze my hand.  Push my arm.  Pull my arm.  Look at the dot on the wall.  Staring at the dot, tell me how many fingers I have up (checking peripheral vision).  Now follow my finger.  Tell me what number you see in this picture of colored dots.  Lie down please.  Close your eyes.  As I touch you with this safety pin, tell me if it is the sharp or dull end.  Dull, sharp, sharp, dull, sharp, dull, dull, sharp…..  Say yes if you feel the tuning fork vibrate as I touch you with it.  Take your left heel and run it up your right shin.  Now reverse. Doc F scratches a key up the sole of my foot to see if it reacts and curls up (the only part of the exam that isn’t comfortable).

What was the result?  I passed with flying colors.  We now had two reports of pretty ugly MRIs but with virtually no physical symptoms at all.  Dr Fundamental said that there was a disconnect but that it happens sometimes.  He does occasionally see patients that have pretty clean MRIs but massive symptoms, and others with bad MRIs that appear to have no symptoms at all.

I fell into the latter category.  The next step was to figure out what had caused it.