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 diagnostic exam, the procedure may take well over an hour. There are far too many tests to discuss in one post so I am going to limit my discussion to the more popular techniques that my personal neurologist performs when I go to see her. This way I can relate my personal first hand experience.
1. They Check Your Reflexes:
One test they may do is to test what is known as your plantar response. The doctor will scrape the sole of your foot with a pointed instrument, beginning at your heel and moving towards the toes. The normal response will cause the toes to curl downward. However, if the toes fan upward and especially the big toe shoots up, then this is called the "Babinski response" which indicates neurological damage. Before my official diagnosis of MS, my general practitioner did this test on me and my response was normal. But I still have MS. So just goes to show you that just because you have MS doesn't mean you will necessarily flunk all the neurological tests.
Your neurologist or doctor will undoubtedly also check your deep tendon reflexes. Everyone has had this done to them, with the little hammer. Your muscles and tendons stretch out when tapped and what they are looking for is whether or not there is symmetry on both sides. Do your reflexes look the same on both sides of your body. Is there a lack of reflex or alternatively do you have exaggerated or rapid fire reflexes which shoot out too quickly? Asymmetry or abnormal reflexes can also be a sign of neurological damage.
2. They Check Your Coordination:
When the docs check your coordination they are also checking to see if there are problems with your cerebellum as this is the part of the brain which controls voluntary movement and motor coordination. And in doing so they are also seeing if you have any type of ataxia, which is a general term used to describe abnormal movements and incoordination.
Here are the tests that my neurologist consistently performs to test my coordination:
a. Rapid back and forth movements of palm up and palm down on my leg. For some folks they may have to slow down and the rhythm may become chaotic. I have always done well on this test thus far.
b. Precision finger taps: This reminds me of part of the chicken dance. You simply take your index and middle finger and tap your thumb rapidly. They check for speed and fluidity of movement. I have also had no problem with this particular test.
c. Finger-nose-finger: This is where you rapidly touch your nose and then touch the doc's finger. They may suddenly move their finger's position to see if you can still touch it or will you shoot over the mark. I sometimes have trouble with this one.