Back from my first ever visit to a neurologist

[Butterfliesrecovery]

Hi guys!

Sooooo...Just got back from my appointment with the neurologist and I explained every type of symptom I've been having, at least those I could remember. hehehehe

Anyway, he told my father and I that he's looking for seizures.."convulsiones" in Spanish.

He's ordered a battery of tests which he stated to be "protocol" for seizures.

1. MRI of brain/head
2. Countless labs..I can't really read which ones they are since his handwriting isn't exactly legible. I read once that's CMP (complete metabolic panel), TSH, ASO...something....eeh I give up..can't decipher them no more.fft:
3. EEG (not 24 hour)
- Evoke Potentials:
-Auditive ( what is this?)
- Inferior Extremeties(what????)
- Superior Extremeties( say what?)

What is evoke potentials?


And that's about it for now...I guess he's doing the basics to rule any differential diagnoses and to have something to work with. Maybe, if the EEG shows something, he'll order an ambulatory one?

Also, the instructions for the EEG said to sleep no more than 6 hours the night before. The technician lady told me to go to sleep at 1 A.M. and wake up at 6.
I then had to go there and get hooked up..and then sleep and stuff.....How is that?
Do they do things to you before you go to sleep? How time do you have to sleep? And when you wake up...are you there for more time until they see how you do after awakening?
Sorry for so many questions!

ugh..I'll look really ugly with my hair all messed up and without product. :S


So..in short, the doctor said that he does not believe the Zyprexa is causing this and is just looking for seizures and/or causes of these jerks.

Oh, and we got an appointment for the EEG on Monday, the 25th! I'm so glad is so close and not dreadfully far away. However, the MRI is another story. Those things are always full. >.< :brain:

Blood tests will be done on Firday morning. eeeeekk

 

[Cint]

Great that you got in to see a neurologist and he's ordered the usual tests when making a diagnosis with seizures. What he meant by "evoke potentials" is they're looking for any neurological/structural abnormalities that may be provoking the seizures. Usually they do EEG's, then MRI's and plenty of blood tests prior to these: CBC, TSH.

A word of caution about Zyprexa: did the dr. also order any urine test? Ask for a microalbuminuria test. This tests the albumin in the urine, checking for kidney problems from diabetes as Zyprexa can/does cause Type 1 Diabetes for some. It did for me. Also ask about an A1c test.

 

[Nakamova]

Also, the instructions for the EEG said to sleep no more than 6 hours the night before. The technician lady told me to go to sleep at 1 A.M. and wake up at 6.
I then had to go there and get hooked up..and then sleep and stuff.....How is that?
Do they do things to you before you go to sleep? How time do you have to sleep? And when you wake up...are you there for more time until they see how you do after awakening?
Sorry for so many questions!

They want you to be drowsy and sleepy when you go in for the EEG. (When you are sleepy is often when abnormal brainwaves will show up in an epileptic brain). The technician will attach the electrodes, and hopefully you will nod off or nap slightly. (They may or may not wait around for you to fall asleep if you're just too perky.) Usually there are two other parts to the EEG test -- hyperventilating and photosensitivity. They do them when you're awake -- either before the sleep part or afterwards. For the hyperventilating part, you're asked to breathe rapidly. For the photosensitivity, they flash lights. Neither of those sections take very long.

Then you're unhooked and sent home -- probably you won't meet with the neurologist until another appointment is scheduled to go over the results.

 

[Butterfliesrecovery]

They want you to be drowsy and sleepy when you go in for the EEG. (When you are sleepy is often when abnormal brainwaves will show up in an epileptic brain). The technician will attach the electrodes, and hopefully you will nod off or nap slightly. (They may or may not wait around for you to fall asleep if you're just too perky.) Usually there are two other parts to the EEG test -- hyperventilating and photosensitivity. They do them when you're awake -- either before the sleep part or afterwards. For the hyperventilating part, you're asked to breathe rapidly. For the photosensitivity, they flash lights. Neither of those sections take very long.

Then you're unhooked and sent home -- probably you won't meet with the neurologist until another appointment is scheduled to go over the results.

Oh..okay. I understand. If by any chance I don't feel any jerks at all during the EEG, is it still possible that myoclonic seizure( or any) seizure activity may happen without the usual manifestation..that it'd be so slight that I won't feel it?
Also, I've read that even people who have frequent seizures( be it myoclonic or other types), have characteristic brain wave patterns on their interictal EEG's. Is this true?

Great that you got in to see a neurologist and he's ordered the usual tests when making a diagnosis with seizures. What he meant by "evoke potentials" is they're looking for any neurological/structural abnormalities that may be provoking the seizures. Usually they do EEG's, then MRI's and plenty of blood tests prior to these: CBC, TSH.

A word of caution about Zyprexa: did the dr. also order any urine test? Ask for a microalbuminuria test. This tests the albumin in the urine, checking for kidney problems from diabetes as Zyprexa can/does cause Type 1 Diabetes for some. It did for me. Also ask about an A1c test.

I did not see any urine test in the order. When I go to the laboratory, I'll see what they have prepared for me...I can't really read what the doctor wrote so I'll be able to read once it's printed prior to the actual blood taking. If those specific tests were not ordered, then I will mention it to the doctor.

I'll get my bloods taken on Friday and probably have the results in by Wednesday considering how many were ordered. But no worries..the lab I go to runs extremely fast!
I hate needles btw :S

My sister doesn't seem to understand this. She had muscle twitches at my age( but not limb movement..just isolated muscle contractions) and had these tests done which showed nothing. She even had the 24-hour EEG.

I got home today and she was just in a bad mood and told me that these tests were not necessary because I don't have anything and they'll all be negative. I really didn't know what to say so I stayed quiet.

She's like that. If you experience a symptom similar to what she has/had, and it was negative for her, then she'll automatically discard any possibility of anything showing up on your results and will actually be very cranky. onder:

Oh, well. That's my sister. I love her so much, really.


Anywho... tomorrow I guess is just a chill-out day until Friday and the days to come. My mom's on the phone with the people at the MRI center. Somehow, she works her "mommy magic" and is able to make appointments for me very soon. I don't know how she does it when everything is clearly booked.
onder: hahahahah that's a mother for ya!

Oh, and in order to make the neurologist understand what I was describing, I did re-enact some of the types of jerks I get as Silat( I think that's his username) and others have suggested. It was kind of embarrasing( can you blame me? I'm 17 with the mind of a 10 yr. old). Nonetheless, he nodded every single time re-enacted my jerks as though they were "textbook" to him.

I did have two subtle jerks at the office waiting for him to come in. My dad didn't notice them but I saw/felt them, as usual.

The doctor looks like a pretty good guy. He's about 45-50 and has this tenderness that naturally appeals to the pediatric population( points at me ).


All in all, I am satisfied with the whole visit and feel like I am in good hands.
He does know English( like every doctor here) so whenever my Spanglish kicked in, he understood perfectly. jajajajajaja couldn't really help it.


Oh! Another thing!

He told me that the medicine I'm taking for my systemic hypertension and mitral valve regurgiation is a calcium-channel blocker. It supress any jerking of the body. So, that drug should have at some degree stopped any minor involuntary movements of the body.

 

[Nakamova]

If by any chance I don't feel any jerks at all during the EEG, is it still possible that myoclonic seizure (or any) seizure activity may happen without the usual manifestation..that it'd be so slight that I won't feel it?

Usually with myoclonics, if you don't feel the jerk, it's not going to show up on the EEG. It might, but it's a lot less likely.

Also, I've read that even people who have frequent seizures( be it myoclonic or other types), have characteristic brain wave patterns on their interictal EEG's. Is this true?

Yes and No. Various ictal (seizure) and interictal (between seizure) EEG patterns correspond to specific seizure types and types of epilepsy, but the correlation varies quite a bit. While the EEG is almost always abnormal during a seizure, it may be normal between seizures -- Some people have the interictal pattern and some don't. It can depend a bit on where the seizures originate, and what they kind they are. For instance, if someone has Absence Seizures, a characteristic interictal pattern is very likely to show up during the hyperventilation phase of the EEG. If the interictal pattern called "spike and wave" appears, that's pretty much a slam-dunk for making an epilepsy diagnosis.

Keep in mind though, that a lack of interictal EEG abnormalities does not exclude a diagnosis of epilepsy. And some people with EEGs that show epilepsy-like activity never have seizures! So the neurologists have to interpret EEG results within the context of other information they are gathering (such as any symptoms you describe or they observe).

 

[Butterfliesrecovery]

oh, okay.

I get it.

Okay, well I'm just praying that whatever it is, the doctor will come to a diagnosis without many tests and stuff.

I remember when my sister had the 24-hour one back when she was 16 (she's 22 now).


hmm...I've had the 24-hour Holter Monitor on three times. If I ever get the 24-hour EEG, then I'm guessing it would feel like the holter monitor but on my head. (?) It was a real bother having to sleep with the wires on my chest and into a fanny pack. ugh