[lwm_rn]

Is it strange that in the workup for my husband's PN he has never had a MRI or any other imaging study? Is that normally done? I would think you would do all the noninvasive studies to rule things out before jumping to all the invasive things.

Some crazy stuff happened this week when trying to get the blood patch for his continued neck pain after his spinal tap. The anesthesiologist (3 in fact) refused to do it unless he had a MRI. They couldn't believe a spinal tap had been done without a MRI or myelogram. They didn't think it was safe to stick another needle in his back without knowing what was going on inside there, especially since he had the new pain/sensations in his foot since the spinal tap. Well, when asked by the anesthesiologist for the MRI order, our neurologist refused! Any idea why? I am actually an ICU nurse who has worked directly with this neurologist before, and I have totally been baffled by how differently he acts when the roles are different. His answer was to send us to another hospital for the blood patch. I reluctantly agreed to do this just to talk to the new anesthesiologist. Well, his opinion was the same so needless to say we NEVER got the blood patch. Luckily, my husband has started to heal on his own and was finally able to go back to work. All the pain and tingling in his feet have resolved to. I, of course, have already looked into a new neurologist!

Oh yeah, the results.....the spinal tap was completely normal as was the fancy blood work they sent off checking for those crazy neoplastic syndromes and stuff. I am relieved, of course, but still no answer!

Is it totally inappropriate to push getting radiology studies especially since now he wants to jump to the nerve biopsy which I don't really feel comfortable doing? My problem is that the first appointment I could get with a new neurologist at our medical college is in January!! Any ideas/suggestions??

Thanks,
Lisa

[glenntaj]

-it's pretty ridiculous--and much against standard protocol--for no imaging studies to have been done.

Generally, since neurological symptoms generated by problems with the central nervous system can exactly mimic those that come from peripheral nerves, one of the first/easiest (though expensive) things tod o is to get MRI's of brain and spine.

Considering all those other tests have come back negative, it does seem increasingly important now to check for brain/spine problems. These tests may come back negative as well, but they do need to be done.

[MelodyL]

The can refuse to do a blood patch??? (after a spinal tap gave the guy a bad reaction).

I am completely baffled.

Melody

[BEGLET]

I had an LP when I first got pn - and within a couple of hours had a severe spinal headache inolving head, neck, sholders, and back.... the pain was so severe just to stumble to the bathroom I felt like I had to hang on to my head to keep it from spinning across the room.... and the only remedy was staying flat on my back in bed for over a week.... it was incredibly painful.. further, my neuro (an Mri had just been done couple weeks earlier to look for MS) told me a blood patch would not be effective in my case becase of the location of the pain - although I was so sick if she told me why I dont remember the reason... I do know she did not think it would help - only laying flat would... and again, it did resolve after about a week.... but I dont think I'd ever have another one - ever! So it appears sometimes a blood patch is useful - but other times - not so....