Wednesday, January 21, 2015

Visit to the Neurologist

The appointment finally arrived. Linda came with to be sure that the important questions got asked.

My goal was to get off Keppra, the anti-seizure medication that I thought was making me irritable and unstable. That didn't happen, but we got to see the MRI image of my brain when I was having those four days out of touch. Indeed there were 5 spots with evidence of some events; but they were scattered about as though some plaque or scar tissue had been disturbed by the stent procedure and moved to various sites around the brain where they coagulated or stopped bloodflow for some short period within the previous 6 hours.

These spots did not account for the fever which I showed for a day or so, and which they treated with antibiotics. There is enough of a chance of an infection occurring at these throttle points that the neurologists recommend staying on the Keppra until they can do another brain scan to see if there continues to be anything abnormal at those sites. I mentioned that I had had an MRI in 2008 when another neurologist worried about the neuropathy I have had in my lower legs for 20+ years. Yup, I can't feel anything and the motor neurons don't work -- the proprioceptive system is dysfunctional so I can't balance on one leg.

Nothing was found in the 2008 MRI and my brain was pronounced "perfect." Not every one has the evidence to say that.

Before our resident could let us go, he needed to have his work checked by the head honcho. Honcho took a quick look and immediately noticed my Bells Palsy, which I have had since 1970. In fact I had been lecturing on the cranial nerves when it hit. Without asking permission he proceded to give a lecture on my symptoms, asking the resident to notice facial synkinesis (when an involuntary act accompanies an intentional one.) I was fine with that, but it was rude of him not to ask for my OK. I learned how they can pinpoint the lesion by noting symptoms such as dry eye or excessive tearing and taste distortion.

The upshot is an EEG in 2 weeks, continued Keppra at the lower dose, no driving for 6 months after the (as yet indeterminate) stroke.

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