Somatosensory evoked response test?
 

So nice to see everyone again! :)

The neuro I saw last week has me scheduled for, among many other things, a somatosensory evoked response (SER) all 4 extremities -- he said he saw some sort of lesion on my MRI spine films that had not previously been picked up by others who reviewed the films and he wants to "explore this."

I've had EMGs/NCS -- bearable and sometimes downright unpleasant.

Any input on this test, and suggestions of what he might be looking for?

The reason for the test, as written on the form, says: "r/o myelitis" and "C-spine lesion."

Many thanks.

SER testing
 

Little Mischief,
So good to see you again! Glad you found us. A lot of us are finding our way back. Here is a basic of the SER test. I'm not sure tho what your neuro is looking for. Maybe Glenn can help?

http://www.sparrow.org/neuro/neuro_ser.asp

Billye

Thanks, Billye; yes, I can see that the community is coming together again.:)

That was a great link, the one I found was nowhere near as informative about the exam itself. I especially like the part about it doesn't hurt.;)

I think I did not do very well on the "tuning fork/vibration" part of his exam, and some of my reflexes were wonky.

Then of course there's the lesion -- I had been told my spine was "lesion free" -- I'll need to ask if this is new or truly something that was missed on a prior MRI done when I herniated a disk in 2000.

Best, Dottye

SEPs
 

They measure how long it takes for a sensory impulse to make it up to the brain, and are generally not used to just make a diagnosis of pn, but to make a diagnosis of multiple sclerosis, or something wrong in the cord. neuropathies of large fiber sensory nerves can make this test abnormal. I think most people with sensory neuropathy will have normal SEPs.

I had them done, and I think they were looking to see if the nerve tracks which give information for balance were impaired. They were not. They are in B12 deficiency states.

So, my guess is they are looking for MS. Which is what you are concerned about, right?

http://www.emedicine.com/neuro/topic344.htm

Well, I have the dx of MS from two neuros going back to 1996, but this is a new doc and I have noticed that neuros tend to want to start from scratch when you walk in the door, regardless of prior diagnoses. A friend was undiagnosed with MS last week, and then diagnosed with Devic's syndrome. Not an improvement, just a change, one that she is refusing to accept.

However, he's the first one to mention a spinal lesion, if indeed that's what it is.

At the appointment, he seemed most interested in sxs of Sjogren's and/or connective tissue disease. I have tested negative before, 4 years ago, on SSA/SSB, he's retesting.

Also, PT/PTT, ESR , ANA, Anti-DNA ABs, extractable nuclear antigens I and II, ANCA, RPR, RA -- I should do this on Halloween, I see many vials of blood in my future. :rolleyes:

I've been supplementing for some years now with Jarrow's Methyl B12 after testing quite low in the range, and when I'm occasionally re-tested I generally exceed the range. Since he has B12 on the lab form, I'll need to remember to tell him that I'm supplementing, and perhaps find the initial labwork for comparison.

I need to pull out your Lizajane.org spreadsheets and update them.

Thanks for the link, that's going to take some reading. :eek:

Best, Dottye

B12 testing
 

Dottye,
Remember Rose's instructions for B12 testing? You need to stop supplementing at least three days before testing and preferably ask for Rose's way of testing see:

http://roseannster.googlepages.com/home


Billye

Thanks, guys--
 

--for listing that link and for describing the evoked potential testing.

I would have come on to try myself, but have had a very hard time getting to the computer lately. Not neuropathy related-- three weeks ago I tore the trapezius muscle, and probably at least one of the rhomboids, in my right shoulder weightlifting. (Wasn't heavy weights, but high reps--and I ignored the original twinges until I really did a number on it.)

The pain's been pretty bad, and the stiffness problematic. Much of the time I resemble a question mark. Physiatrist discussed surgery, but I can't afford to be flat on my back (which hurts anyway) for any length of time--we're right in the middle of heavy test prep season--so we've been going conservative with PT (TENS, ultrsound, myofascial massage, gentle stretches). Still find it very hard to sit in the arms perpendicular typing position for any length of time--really pressures the whole area I've made a number of adjustments to the chair and desk in my workspace to try to help.

Probably looking at a 6-8 week healing process, at least. Meantime, I'm not exercising except for some walking and the stretching, and I feel like a fat lump (sigh). Not enough endorphins.

Thanks, Billye, I have that new site bookmarked (and am so grateful to Rose for working to put all her info in a safe place on line). I had referred so many folks to that BT Sticky, it's good to have this direct link.

I'm testing this week, and have already stopped my daily dose of B12 -- but I'll make certain it's at least 3 days since my last supplement, and I'll let the doc know as well.

He's testing Folate, but I don't see Hcy or MMA. Hmm... but I have those #s from testing Nov 2005, along with my B12 from that test as well.


Thanks, again, for the reminder.:)

Best, Dottye

Glenn, this sounds bloody awful, I'm sorry you're in so much pain. :(

I'll keep you in my thoughts for a full and speedy recovery.

Best, Dottye