The Neurological Exam: What do they do and what are they looking for?

By Merely Me, Health Guide Wednesday, February 04, 2009
So what does happen when you go to see a neurologist and they do an exam?  I do think the procedure differs from doctor to doctor and depending upon what they are looking for.  When I see my neurologist, the exam does not take that long.  But for someone undergoing an extensive diagnos...
2/ 4/09 12:16pm

I know that was just a sampling of the tests, but do they still stick the long needles in your fingers and hook you up to the battery charger to see if the nerves are working properly?  I said to the tech that day, after he already told me what it was, "no, really, that looks just like a battery charger"

Merely Me, Health Guide
2/ 7/09 10:37am

I did not have this done to me!  I think I would have ran out of there.  Smile

 

I did have evoked potentials where they stuck all the wires to my scalp and all.  But I have never had this nerve conduction test.  Thanks for bringing up this topic!

2/ 4/09 12:44pm

Because of peripheral neuropathy, I know these tests, and have some of these every six months or so. I really think my neurologist makes me walk heel to toe, just so he can have a laugh. I think routine exams get boring for them.

 

I have had a couple nerve conduction tests some years ago, like Andy mentions. I've learned a few things today, like why they do certain tests, and what they look for. I don't think I'd try the Wii Fit, it seems easier just to fall down and get it over with. Smile

Thanks for the information, Merely Me.

Merely Me, Health Guide
2/ 7/09 10:40am

Wow...I feel left out as I have not had this nerve test.  Yeah I am good at falling down without a game to tell me I am imbalanced.  Thank you for reading and offering your experience.  It is much appreciated as usual.

Anonymous
Anonymous
2/ 4/09 4:15pm

Great post, but you left me wondering on one thing.  You state that neurological tests are done for mood.  I was wondering how that would be tested  and would it not vary depending on the given day?  Maybe you could follow up on that one day with a post.  Thanks

Merely Me, Health Guide
2/ 7/09 10:44am

Hello and yes I will have to do that.  There are a lot of tests to talk about with relation to MS!

Anonymous
Anonymous
2/ 9/09 7:40am

thanks again

2/ 4/09 5:10pm

When I had my last nerve conduction test in January, my Neurologist swabbed the site (upper right arm) where she was going to plunge the first needle, and I waited...and waited...then she said, "uh - you don't feel that at all, do you?"  I looked to the side and the needle was in there already.  I said, "oh, yeah, there it is".  She replied, "yes, it's in there about a half an inch." 

 

Then she wiggled it around, to which I responded, "I actually can feel that." 

 

"Does it hurt?" 

 

"Not really."

 

"Well, I'm guessing you might feel this one a bit more."  She popped the needle in my right leg, just below my knee, and I just about levitated off the mattress. 

 

"YEEEEEOOOOW!!" 

 

"Ah, that's the response I should hear."

 

Then she announced that the next location was going to be the muscle in that web between the right thumb and forefinger.  As I braced for the worst, she stuck it in and I only felt a mild sensation.  Which, of course, was a relief at the moment, but further indication of something being amiss in the peripheral nerve world.

 

You know, some folks have difficult disabilities that are really quite boring.  One thing you can say about disorders of either the central or peripheral nervous system:  They aren't boring!

Merely Me, Health Guide
2/ 7/09 10:47am

Oh my goodness!   This sounds like some sort of barbaric torture.  You poor thing!

 

Thank you for describing this experience with such detail.  I had no idea.  And you are so right...our disease is quite intriguing and never dull.  I think I would rather deal with a more boring existence myself.  Smile

 

I do appreciate your comments and insights...keep 'em coming!

2/ 5/09 10:33am

This chain of comments has been very interesting to me. I've never heard of this nerve conduction test -- and after reading comments by those who have had it done, I'll never agree to it! It sounds bizarre.

Would one of you who have had this done let me know what the doctor can do once they've figured out you have a problem in this area? Do they prescribe medication or is there something else that rebuilds this area?

I wonder if my doctor was trying to gain the same information by doing the 'tuning fork' test, where he struck a tuning fork again a hard surface to get it vibrating and then set it against my legs and feet to see if and how long I would feel it. Anyone know?

2/ 5/09 2:06pm

The test isn't that bad, Julie and it is very common. You really don't feel the needles, or I didn't. They put them in various areas, in my case, the arms and legs. They, being a neurologist, who usually specialize in doing these type of tests. Both of mine did.

They confirm nerve damage, to myelin sheaths, and probably to the nerve it covers. It is only a diagnostic test, not a treatment,  a tool to confirm nerve damage and it's extent. Mine was for peripheral nerve damage which slowly spreads from the toes and fingertips upwards. In my case, they don't know why, for more than a decade. About, 30% or more, never find out why.

 

Hope someone with MS answers with their experience, it has to better than this :)

 

I get that tuning fork test every time I see my neurologist, never have asked him why. Someone here knows.

2/ 5/09 2:56pm

As for what they do it for, my best understanding is that it has to do with trying to figure out if your problems are due to peripheral nerve issues or central nervous system issues.  If they determine that the peripheral nerves are the problem, then that pretty much rules out MS and opens up the possibility of one of the many peripheral neuropathies.

 

As for the vibration (tuning fork) test, my Neurologist said that some disorders have the effect of making some nerves be able to sense pain/pressure but not vibration.  Sure enough, I didn't feel the vibrating fork against my elbow and thought it had "worn off", but when she then placed it on my chin I felt a strong vibration.  My nerves are shot!

Merely Me, Health Guide
2/ 7/09 10:49am

Thank you Julie for asking...I can see this is a topic we need to explore more on this site!

2/ 5/09 11:02pm

Good article and each one of the tests you mentioned I have had on numerous occasions well as many more. I believe that they tailor certain tests to focus on the symptoms one has been having. If so this would explain why some tests aren't used on some patients.

 

Another outstanding job!

Merely Me, Health Guide
2/ 7/09 10:51am

Thank you so much Larry and if you ever have the chance to share about what tests you have undergone...I am sure the community here would love to hear about them.

 

 

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By Merely Me, Health Guide— Last Modified: 04/25/13, First Published: 02/04/09