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Forum Name: Neurology Topics

Question: Lumbar Puncture, NOOOOOO. Positive Babinski & Tingling


 thester6474 - Fri Nov 30, 2007 4:32 pm

User avatar I am a 25 year old female that has been tested by many different doctors, 2 of which are Neurologist, 2 of which are Rheumatologists, 1 General Practitioner, and 1 Ear Nose & Throat Specialist. At my last appointment with my Rheumatologists they both agreed that I have Fibromyalgia, Myoclonus, Hypermobility Syndrome & Neuropathy. They also agreed that I have a Rheumatic Condition, but they were more worried with my Neurologic Condition. Kind of apprehensive, I went to visit the first Neurologist I had seen, and wasn't to sure about the first time. This time like the many other times, he said that it was not Neurological. This doctor performed very little tests during my Neurological Exam both times. The second Neurologist had me doing lots of different tests, checking balance, my reflexes while I sat up, and my reflexes while I laid down. Noticing that I was unable to feel when he would hit my knee, legs while trying to get a reflex. He also noticed that I had a positive Babinski reflex only on my right side. My General Practitioner administered the same test and got the same results. WHAT IS THE IMPORTANCE OF ME HAVING THAT REFLEX? So this Neurologist ordered a MRI of my Cervical Spine and Thoracic Spine with and without contrast, as well as a Lumbar Puncture. I am so scared of this procedure. I have a lot of symptoms and they are very broad. My main symptoms are tingling in my entire body, burning pain, weakness & fatigue in the muscles, stiffness, depression, headaches, irritability, anxiousness, tremor, proprioceoption, major muscle cramps and spasms, a decreased ability to feel pain & heal from it. I sat on a piece of glass, and was bleeding all over the bed, when I stood up is when I noticed that I had been injured. I also suffer from malaise, frustration, difficulty with memory, concentration & thinking. I also have a lot of problem doing small muscle activities and major varicose veins. Could this be just a Circulatory problem, or is it Neurological/Rheumatic? What is the significance of the Lumbar Puncture with my Neurologist? I have it in two weeks, and then I have to wait for the results, and the wait time is about to kill me. Also for how long will I have to lay down at the doctor's office after the Lumbar Puncture? Thanks so much for your help.
 Dr. Chan Lowe - Mon Jan 21, 2008 1:28 pm

User avatar Hi Thester6474,

I agree with your second neurologist regarding the need for these tests. Your symptoms definitely fit a neurological problem. The nervous system can loosly be broken into two areas, the central and peripheral nervous system. Initially your symptoms sound like they may all be due to a peripheral problem. However, a positive babinski indicates a problem in the central nervous system.

Basically, the babinski reflex is a reflex that is normally present until the central nervous system (the brain and the spinal cord) suppress it. When it becomes positive again it indicates that there is something stopping the suppression from the central nervous system. This is why your neurologist has recommended the MRI.

I suspect the lumbar puncture is to help evaluate for multiple sclerosis and other central type problems where there is an increase in protein or other specific markers in the spinal fluid. This is a helpful and important test.

The LP itself is actually quite simple even though it sounds bad. A small needle is inserted into the spinal space. It goes below where the spinal cord stops so that there is no risk of poking the spinal cord. A small amount of fluid is collected and sent to the lab. After the fluid is collected the needle is removed and the procedure is done. You will likely be lying down for this. The procedure usually takes around 15-20 minutes and they'll probably want you to lie on your back for about an hour or so afterwards. They may also be able to give you some medication to relax you and make it so you don't remember the procedure afterwards.

Best wishes.

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