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philo
Trad climber
Somewhere halfway over the rainbow
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Topic Author's Original Post - May 4, 2011 - 09:48pm PT
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Any body know anything about these conditions?
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pat
Trad climber
estes park
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We studied it in Nursing school, so I am no expert, but I know a bit. I have my textbook here as well. Can you describe a bit more about what is going on, or what you want to know in particular? Are you concerned about something going on with yourself, or another person? What exactly is happening? Or are you just interested in the physiology behind it?
-Patrick
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philo
Trad climber
Somewhere halfway over the rainbow
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Topic Author's Reply - May 5, 2011 - 12:12am PT
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Pat, it is a bit difficult to explain. PM?
Goatboy, WTF?
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pat
Trad climber
estes park
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Go ahead and PM, I'd be happy to respond, though I'll be off climbing in Eldo tomorrow so I won't be able to get back right away. Coincidentally I am climbing with a Nurse Practitioner who probably knows a bit more than me about it.
Clinically diagnosed Clonus is quite a serious possible sign of upper motor neuron disease, such as MS, Stroke, or possibly tumor. The problem is that a lot of people self-diagnose things over the internet and often get all worked up about the side effects of drinking say too much caffeine all while ignoring more pressing matters, or less obvious but more ominous signs of something. That's why I was asking for a bit more detail.
As far as I know the clinician (doctor or nurse) performs a test by dorsiflexing the foot (pushing the foot towards the shin) and tapping on the Achilles tendon with a reflex hammer, or by just holding the leg at the knee joint in one hand, and briskly dorsiflexing the foot with the other hand. Clonus is defined as 5 or more rhythmic reflexive contractions (one right after another) in any reflex (but is most often tested for using the above achilles deep tendon reflex test I believe). Not a really difficult test, but not one you could accurately perform on yourself.
Hyperreflexia is an exaggerated reflex response, i.e. abnormally brisk
(whereas clonus is a set of rapid rhythmic contractions of the muscle attached to the tendon). The problem is that there is a very wide range of reflex responses in a wide variety of individuals, and those responses can be influenced by something as simple as general mood. Any abnormal reflex response has to be taken in the context of a thorough neurological exam, the past history of the patient, and has to be compared side to side. Clonus in the presence of hyperreflexia would be a definite cause for concern. Hyperreflexia by itself, well it depends in the context of a neurological exam, many people have abnormally slow or fast reflexes.
Anyway hope this helps a little. PM me a bit more about what exactly you are wondering about and I at the very least can quote my text books, or direct you to the appropriate resources, or say if something truly sounds alarming. If you are really concerned about something it is always best to see your doctor of course.
-Patrick
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rhyang
climber
SJC
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I get clonus in my left calf at times, as a result of a contusion of my cervical spinal cord about four years ago -- it happened when I broke my neck in a car accident. Clonus feels sort of like elvis leg, but isn't the result of fear or tired muscles. Rather inconvenient on lead, let me tell you..
The nature of my injury (brown sequard syndrome) seems to makes the reflexes in the left leg more pronounced, among other things .. my neurosurgeon demonstrated with a reflex hammer on both knees: the right one kicked out normally, but the left one kicked out way more.
I get the impression from my reading that there are both excitatory and inhibitory "circuits" in the spinal cord .. perhaps hyperreflexia is what happens when some of the inhibitory circuitry has been damaged.
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neebee
Social climber
calif/texas
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hey there say.... well, i WAS going to do my chores,,, but i saw this:
say, philo.... sure hope all is well and that perhaps this is not the trouble....
god bless to all concerned in this matter...
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philo
Trad climber
Somewhere halfway over the rainbow
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Topic Author's Reply - May 5, 2011 - 09:26am PT
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I may know more by this evening. Thanks for the info.
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neebee
Social climber
calif/texas
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hey there philo... say, how are you doing...
hope you learned something better, or that things are not so bad...
just checking on you...
*won't be back til tommorrow...
been working hard on a lot of things around...
miss the ol' supertopo... :)
you are in my prayers...
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philo
Trad climber
Somewhere halfway over the rainbow
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Topic Author's Reply - May 7, 2011 - 10:37am PT
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Thank you Neebee and the TacoTribe.
I have definitely been diagnosed with Hyperreflexia and Clonus. The question is What is causing it. Is it something bad or just annoying? ??? I wonder how long I will have to wait for test results. The last time I spent 4 months agonizing about amputation before they got the results back to me. Hopefully this time will be a bit more expedient.
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philo
Trad climber
Somewhere halfway over the rainbow
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Topic Author's Reply - May 14, 2011 - 10:41am PT
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Annoyingly I have yet to hear directly from the Neurologist. But my GP/MD says that the MRIs don't appear to show any lesions or tumors on my thoracic and lumbar spinal regions. That is great news as it pretty much rules out MS & ALS. But it still doesn't answer why my one leg has gone all 'Elvis' on me.
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philo
Trad climber
Somewhere halfway over the rainbow
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Topic Author's Reply - Jun 9, 2011 - 12:33pm PT
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Oh well two more MRIs this Saturday.
Cervical spine scan should take 30 to 40 minutes in the tube.
Brain scan is expected to take 90 minutes.
What if after 5 minutes they discover that I am really the straw man ( "If I only had a brain") from the Wizard of Oz. Will they continue charging me for another 85 minutes? Or will it be "Nothing to see here, move along"?
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Ksolem
Trad climber
Monrovia, California
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Philo,
I hope it turns out to be nothing, maybe an elecrolyte imbalance or some such thing.
I've been travelling the road of neurology for five years now. Some things I've done which really paid off...
Find a neurologist who is strong on nutrition, supplements etc. I found one who is a Dr of Neurology, Osteopathy and a nutritionist, and she does triathlons which means when it comes to sports she really gets it.
Go into every Doc appt with a written list of questions, concerns etc. Write down the answers.
Keep a diary from the day you first noticed the weirdness. From your diary create a written chronological record recording any symptoms, changes in symptoms etc., every Doc appt., every med and change in meds. Bring this chronology to every appt. Your docs will really appreciate this.
Be pro-active. Your Docs will appreciate it and respect you for it.
Good luck.
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philo
Trad climber
Somewhere halfway over the rainbow
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Topic Author's Reply - Jun 10, 2011 - 11:09am PT
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Ksolem that is great advice. Thank you!
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Brokedownclimber
Trad climber
Douglas, WY
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Jun 10, 2011 - 11:25am PT
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Phil-
There's a really great neurologist in Casper; he's the one who did the diagnosis on my wife. Not only a Stanford Med School Grad but also a Ph.D. in neuroscience as well as an M.D.
PM me for full information.
Rodger
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philo
Trad climber
Somewhere halfway over the rainbow
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Topic Author's Reply - Jun 18, 2011 - 02:01pm PT
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Okay gang here is the latest. I have had my full spine and brain scanned with MRIs. The brain scan was strange as they lock you into a head rack that resembles a medieval torture device. That scan took 90 minutes. I could have told them that only "Custer" remained but they opted to bill me for full time anyway. Then I had a neural mapping done which I would not recommend as it involves being willingly electrocuted and having long needles imbedded deep in muscles and nerve bundles.
That whacked me out for the rest of the day. The MRI tube is a pleasant nap comparatively.
Anyway the good news is that there is no evidence of MS, ALS or any motor neuron degeneration.
What does show up is five strangulation points in my cervical spine. Most of my spinal cord looks like a long, smooth, even sided worm of playdoh that as kids we used to roll out. Then in mid cervical region it looks like some large hand crushed it, finger indents and all. That explains alot!! So I am off to see a team of Neurosurgeons to discuss the future. The Neurologist has all along indicated surgery as the likely outcome. I asked her "What was the alternative to spinal surgery" and she replied "Not having surgery". I asked "Then how I can cure the clonus" and she said "surgery".
Hmmmm. They medicos are all taking this very seriously in an ASAP sort of way so maybe I should pay attention for a change. But, after conferring with the slice and dice dudes, I will still explore alternatives.
Oh yeah I almost forgot, it does appear that I actually have a brain. Who knew.
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Reilly
Mountain climber
The Other Monrovia- CA
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Jun 18, 2011 - 02:49pm PT
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Philo,
I'm so happy to hear the relatively good news and the latter discovery certainly
puts you in rarified company hereabouts. I'm sure you are going to exhaust
all alternatives before the "Day of the Long Knives". Wish I could help.
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Brokedownclimber
Trad climber
Douglas, WY
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Jun 18, 2011 - 05:01pm PT
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Philo-
First, wishing you all the best. Is there any possible connection between a possible whiplash injury that you simply shrugged off at some point?
I'm really glad to hear that there is no evidence of neural degradation. There may be a possible treatment for your condition called "adipose mesenchymal stem cell replacement therapy." It isn't yet an FDA approved therapy but it is widely performed in Germany, Panama, Mexico (by American physicians), and China...just to name a few. We can discuss at the HH next week, if you like...
rodger
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neebee
Social climber
calif/texas
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Jun 18, 2011 - 07:58pm PT
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hey there say, philo.... thanks for the update... as you know, we all wonder how climber-forum-folks are doing whenever someone here, is injuried, sick, over-tired, or has trouble of any kind...
will keep on praying, too, of course... and wishing for this to get fixed as best it can and should...
take care in the mean time, to whatever your part is...
god bless...
:)
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SteveW
Trad climber
The state of confusion
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Jun 19, 2011 - 12:24am PT
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Hey Phil, let me know if you need anything.
Wishing you the best, as always.
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