HOWDY! Here's the 4th installment in this series DEMYSTIFYING THE NEURO EXAMINATION! I Hope you enjoy it! Here are links to all 4 videos: SHARE vid DECODE BALANCE & COORDINATION EXAM: th-cam.com/video/IsuE8mlqGJQ/w-d-xo.html SHARE vid DECODE SENSORY EXAM: th-cam.com/video/aA221SvwTCQ/w-d-xo.html SHARE video DECODE EYE EXAM: th-cam.com/video/tJvHbk9wsEI/w-d-xo.html SHARE video DECODE MOTOR EXAM: th-cam.com/video/H7WtLcQruEY/w-d-xo.html
I really have enjoyed this series greatly because it educates us on what is being looked for. Can you look at the back of our eyes to determine disability progression? Thanks so much!!
wish I had found you before-I was diagnosed in 1985, ended up in a wheel-chair in '95-now I am proud to say I'm 70 because I never thought I'd make it this far. I am originally from Chicago but live in Italy now for 50 years. I was 36 when I was first diagnosed here in Italy by a very great neurologist who, unfortunately died of a tumor about 10 yrs later and I never found someone as great as he was to substitute him-after all these yrs., I'm really quite tired of all this!
Thank you very much for these videos. I am due to see a neurologist this week (uk). When my symptoms began I saw a neurologist who was so nasty and dismissive he had me in tears and I’ve never forgotten his attitude. I wish you were my doctor.
You've given me a lot to talk to my neurologist about......I'm 19yrs in and finally learning what's happening to my body. I understood about Mylan and what's happening with that but all this other stuff, I had no idea. Thanks Doc.
Another awesome video! This particular one is of great interest to me, these two areas are where the majority of issues are for me. Thank you for making them easy to understand.
As usual. awesome video I have contrast issues, so differentiating between subtle colors as well as light/shadows. This becomes a balance problem when am climbing down the stairs, looking away from direction of light. I tend to overstep and thankful for the handrails those times, Murmur Choicest expletives then (Usually in mother tongue) :-)
Great video as always! Again, thank you for making this series (and thanks to Amber). This series has been very informative and interesting. It's amazing how complex things that we don't even think about really are.
Hi Dr Boster, Thank you for this video; 15 years of MS Specialist Mysteries have been solved!!! My question is regarding tandem walking. I have failed the tandem walk for 15 years. When I would do the movement it was like the muscle wasn’t there and I would stumble and loose my balance, and quit so I wouldn’t fall. I am in a clinical trial for the remyelination drug elezanumab, phase 2a. Since starting the trial, during my clinical exam portion ( I think it was after three infusions) I aced the tandem walk. I first discovered I could do it during physical therapy and I noticed two changes. One change was there was a change in my thought process. I stopped thinking I haven’t been able to do this for 15 years. Second I conscentrated on my core and I felt the connection to my muscles. I know you can’t answer this because none of us knows if I’m really receiving the drug. But hypothetically could repair to my cerebellum be taking place? Could this repair be responsible for my improvement in the tandem walk? I have thought maybe it was just at the coaching of my physical therapist, who is very, very awesome. However, it is almost like a grew a new muscle, one that I haven’t felt a connection to in some time. In fact a week ago I did a balance beam, the short brick barrier walk between my house and my neighbor’s. I had my six year old daughter film it. It’s posted on my Facebook group directed at others in the same trial as well as MSers. facebook.com/groups/499522823978787/?ref=share
Thank you Dr Boster. It’s fascinating to understand the mechanics behind the Neuro exam, particularly this one (for me) about balance. My balance is pretty rubbish, I feel like my muscles around my lower back are stiff and don’t work properly. I do exercises daily to keep them loosened up and functioning best they can. Really REALLY enjoying your videos, and gaining lots of knowledge from them. Thank you - Neil (UK).
I just love these videos Dr. B! So helpful. And that finger nose finger test gets me every time, good to know your learning something more than just how to duck and weave from my flailing finger coming at ya! Lol
Brilliant video Dr Boster. Recently my balance has declined and I've had a couple of falls (not my most graceful of moments!) so the topic of balance is extremely important to me. I was wondering: are there other areas of the brain MS affects, apart from the cerebellum, that can contribute to poor balance and if so, how do neurologists identify this? Thanks again, these videos put a smile on my face. It's empowering to learn and understand better. Take care! 😊
that's a really big topic. In my sensory video I share how we use the rhomberg exam- which involves sensory info, vestibular info and cerebellar info to keep out balance when standing. th-cam.com/video/aA221SvwTCQ/w-d-xo.html start at 4:14
Great video. Amber, I wish I could walk like you! Thank you for teaching us for about the visit. I will work on tandem walking in the hall for exercise..... Larry will walk with me and keep me vertical.
Most excellent question Jennifer! There are different set of observational assessments when working with someone in a wheelchair. For example we will look at..sitting posture supported with arms, sitting posture without using arms, ability to transfer/stand/pivot, ability to maneuver chair, perform wheel-e, etc.
Is the gait analysis the same as Dynamic Gait Index test? Would one replace the other, or are they done for two completely different reasons? Thanks Doctor Boster.
Great video. There is a catch-22 to this balance issue. I am slow & careful (a couple of falls taught me my lesson) but this also caused a burdensome weight gain. Please address this issue & don't say exercise that's how I got hurt the first time. I'm talking 25 lbs.
Thank you. They did a very simplified neuro exam when I was in at my neurologist for a work in appointment. Not diagnosed with anything right now. Is it a common occurrence for people in general to not be able to walk on their heals without losing their balance?
I’ve had MS for 30+ years and have never had a neuro do some of these. My main symptoms are dizziness and vertigo. Alaska is not the best place to have ms.
they are wizards of the eye exam. They will lead you through a series of questions to help them sort out what's going on. Just answer to the best of your ability!
I was diagnosed with MS about 3 weeks. I have struggled with balance and vertigo along with slight numbness on my left side to include the left side of my tongue. I have a moderate size lesion on the right side of my brain and some small scattered old lesions. My MS specialist told me I have no lesions on my spinal cord and cerebellum so he was surprised that I have the vertigo and balance troubles. They are my most bothersome symptoms. If a lesion on my cerebellum is not the cause what is?
Thanks for this video, Dr B. I didn't realise it's the cerebellum. My speech is apparently clearer now (saw neuro a few days ago). But my singing is terrible now, can't hold a tune at all.
My neurologist doesn't always perform these tests and there are some you showed that I have never had. Could this be because he already knows certain things about my status and doesn't need to "beat a dead horse", or could he just not be being real thorough in his examination? Thank you for your time in posting the video and for reading/addressing my querry! - Raymond
yes that is possible. I don't exam people in follow each visit. I often times use standardize testing (low contrast vision, nine hole peg test, timed 25 foot walk and cog screening tests) to guide me. Then I'll do a "spot" exam on systems I'm concerned about.
Hi I have noticed my balance being off a couple months ago. I can’t balance with eyes closed and feet together and I can’t walk heel toe at all. I’ve been having issues with lightheaded feeling a lot the last few weeks and I also have trigeminal neuralgia. Do these sound like Ms symptoms? im a 60 year old woman. No cardiac problems
Thanks for another video on the balance and coordination Somebody threw a grenade in my cerebellum :/ Are these retrainable in some way? Is it actually worth the effort of trying to? I’ve had some therapy years ago using a wii with balance board Actually thinking (again) of buying one and transforming my “training room” into a “safe room” with pillows and stuff to make falling less dangerous
Hi, Interesting video. My balance has really suffered and I am using a wheelchair at the moment. I noticed that my muscles really suffered after starting to use it and I have been trying to train my muscles so I could hopefully start to walk again at some point. Is it plausible that I would regain the balance (meaning heal the part of the brain that controls it) so I could hope to start walking after some training? Have you had patients in this kind of situations I am still very hopeful about my own situation as I am not noticing any mental issues at the moment. Thanks for making these awesome videos.
I can't comment on your specific situation without examining you, reviewing your MRI scans, etc. To speak in generalities, it's hard but it is possible to retrain aspects of balance and coordination. Hope this helps and keep fighting Daedana!
@@AaronBosterMD Hi Doc, Thanks for your answer, It contained the information that I hoped to get on this situation. I understand that you cannot give further advises because there is so little information here for you. I will continue with the diet (mostly plant based) diet and exercise as recommended. On the positive side, my arms have gained some muscles because of the use of wheelchair, so it is not all bad. :) Your comment made my day and keep making the awesome content here. I am writing this from UK, so you are getting international fans with the channel.
Hmmmmm, I used to throw a mean game of darts and stopped after diagnosis had me in a chair for a while. After I regained my ability to stand and walk somewhat normally I tried throwing some darts and I could barely even hit the dartboard, much less play a game. It feels totally foreign now, either hand. I can still throw a tomahawk but that is much more gross motor movement and less detail throwing. It’s just not a good idea to throw tomahawks in the house. At least my wife doesn’t think so. I guess it keeps the paint costs down. Blessings!
HOWDY! Here's the 4th installment in this series DEMYSTIFYING THE NEURO EXAMINATION! I Hope you enjoy it! Here are links to all 4 videos:
SHARE vid DECODE BALANCE & COORDINATION EXAM: th-cam.com/video/IsuE8mlqGJQ/w-d-xo.html
SHARE vid DECODE SENSORY EXAM: th-cam.com/video/aA221SvwTCQ/w-d-xo.html
SHARE video DECODE EYE EXAM: th-cam.com/video/tJvHbk9wsEI/w-d-xo.html
SHARE video DECODE MOTOR EXAM: th-cam.com/video/H7WtLcQruEY/w-d-xo.html
1. I'd also love to hear your thoughts on this video?
2. What's your level of interest in more videos on this topic of decoding the neuro exam?
You're welcome Chuck O!
I really have enjoyed this series greatly because it educates us on what is being looked for. Can you look at the back of our eyes to determine disability progression? Thanks so much!!
Can drunk feeling and disoriented feelings are symptoms of MS ?
Hiya Dr Boster, wow u answered me…Thank you, I absolutely wasn’t expecting that..
wish I had found you before-I was diagnosed in 1985, ended up in a wheel-chair in '95-now I am proud to say I'm 70 because I never thought I'd make it this far. I am originally from Chicago but live in Italy now for 50 years. I was 36 when I was first diagnosed here in Italy by a very great neurologist who, unfortunately died of a tumor about 10 yrs later and I never found someone as great as he was to substitute him-after all these yrs., I'm really quite tired of all this!
Howdy Joyce! Where abouts in Italy do you live, may I ask?
Thank you very much for these videos. I am due to see a neurologist this week (uk). When my symptoms began I saw a neurologist who was so nasty and dismissive he had me in tears and I’ve never forgotten his attitude. I wish you were my doctor.
You've given me a lot to talk to my neurologist about......I'm 19yrs in and finally learning what's happening to my body. I understood about Mylan and what's happening with that but all this other stuff, I had no idea. Thanks Doc.
Another awesome video! This particular one is of great interest to me, these two areas are where the majority of issues are for me. Thank you for making them easy to understand.
YW Paul!
These videos are amazing and very informative. Thank you Dr. Boster!
Wow great stuff, thanks..
LOVE this series!!!❤️
super glad to hear that Candy!
Great sir
This was an awesome series Dr. B thanks! I've actually watched it twice.
Thank you Mrs. Studge! I'm super glad you found it helpful!
Thank you for this video 📹
Great as always ❤️
TY stjernoga!
Very cool how these little actions can tell you what's going on in certain parts of the brain. Amazing. Thanks!
Right on Maggie Mae. The neuro exam is awesome and powerful stuff!
As usual. awesome video
I have contrast issues, so differentiating between subtle colors as well as light/shadows. This becomes a balance problem when am climbing down the stairs, looking away from direction of light. I tend to overstep and thankful for the handrails those times, Murmur Choicest expletives then (Usually in mother tongue) :-)
Right on Raguraman! In case you didn't see this one, here's a bit more on balance: th-cam.com/video/YmHOgkXfJvQ/w-d-xo.html
Thanks for the information. I love reading the comments from fellow MS sufferers - it’s good to know I am not alone and these symptoms are real.
Thank you Dr
YW Jorge!
Great video as always! Again, thank you for making this series (and thanks to Amber). This series has been very informative and interesting. It's amazing how complex things that we don't even think about really are.
YW Erin! I'll share you comment with Amber as well!
Still loving the love the videos keep them coming
right on Kevin!
great video again. Thank you.
YW Rose
Thank you so much dr Aaron for teaching us this amazing info. Just like we are a MD students, i love it 👍🏻
YW Uhoud!
I understand thank you.
awesome sauce!
Thanks for another informative video Dr.
YW Sravani
Thanks for another informative video. I finished my second infusion of the first Ocrevus dose today and so far so good! YAY:-)
Right on Lynn!
Hi Dr Boster,
Thank you for this video; 15 years of MS Specialist Mysteries have been solved!!!
My question is regarding tandem walking. I have failed the tandem walk for 15 years. When I would do the movement it was like the muscle wasn’t there and I would stumble and loose my balance, and quit so I wouldn’t fall.
I am in a clinical trial for the remyelination drug elezanumab, phase 2a. Since starting the trial, during my clinical exam portion ( I think it was after three infusions) I aced the tandem walk. I first discovered I could do it during physical therapy and I noticed two changes. One change was there was a change in my thought process. I stopped thinking I haven’t been able to do this for 15 years. Second I conscentrated on my core and I felt the connection to my muscles.
I know you can’t answer this because none of us knows if I’m really receiving the drug. But hypothetically could repair to my cerebellum be taking place? Could this repair be responsible for my improvement in the tandem walk? I have thought maybe it was just at the coaching of my physical therapist, who is very, very awesome. However, it is almost like a grew a new muscle, one that I haven’t felt a connection to in some time.
In fact a week ago I did a balance beam, the short brick barrier walk between my house and my neighbor’s. I had my six year old daughter film it. It’s posted on my Facebook group directed at others in the same trial as well as MSers. facebook.com/groups/499522823978787/?ref=share
Thank you Dr Boster. It’s fascinating to understand the mechanics behind the Neuro exam, particularly this one (for me) about balance. My balance is pretty rubbish, I feel like my muscles around my lower back are stiff and don’t work properly. I do exercises daily to keep them loosened up and functioning best they can. Really REALLY enjoying your videos, and gaining lots of knowledge from them. Thank you - Neil (UK).
TYVM Neil! Here's a vid I did on balance you might find helpful: th-cam.com/video/YmHOgkXfJvQ/w-d-xo.html
@@AaronBosterMD Thanks very much, I'll check it out.
Another mystery solved. Thanks Aaron.
YW Ken!
I just love these videos Dr. B! So helpful. And that finger nose finger test gets me every time, good to know your learning something more than just how to duck and weave from my flailing finger coming at ya! Lol
ha!
Brilliant video Dr Boster. Recently my balance has declined and I've had a couple of falls (not my most graceful of moments!) so the topic of balance is extremely important to me. I was wondering: are there other areas of the brain MS affects, apart from the cerebellum, that can contribute to poor balance and if so, how do neurologists identify this? Thanks again, these videos put a smile on my face. It's empowering to learn and understand better. Take care! 😊
that's a really big topic. In my sensory video I share how we use the rhomberg exam- which involves sensory info, vestibular info and cerebellar info to keep out balance when standing. th-cam.com/video/aA221SvwTCQ/w-d-xo.html start at 4:14
Great video. Amber, I wish I could walk like you! Thank you for teaching us for about the visit. I will work on tandem walking in the hall for exercise..... Larry will walk with me and keep me vertical.
right on! If you haven't seen it yet, please check this vid on balance: th-cam.com/video/YmHOgkXfJvQ/w-d-xo.html
I rewatched and am ready to tandem walk. I will keep cane (Larry Bird) and Louie (lab/mastiff) with me
Thanks Dr. B. You’ll talk about how much you learn by observing patients stand/walk, but what about those who are wheelchair-bound?
Most excellent question Jennifer! There are different set of observational assessments when working with someone in a wheelchair. For example we will look at..sitting posture supported with arms, sitting posture without using arms, ability to transfer/stand/pivot, ability to maneuver chair, perform wheel-e, etc.
Again very helpful and informative. I really can't thank you enough Doctor. Man I wish I could just get well again. MS stinks. Thumb's up video!~John
YW John!
What about the one where you're sitting on the exam table and they push down ind2 on each leg? This one seems to concern my doc but I don't know why?
ind2?
Is the gait analysis the same as Dynamic Gait Index test? Would one replace the other, or are they done for two completely different reasons?
Thanks Doctor Boster.
Great video. There is a catch-22 to this balance issue. I am slow & careful (a couple of falls taught me my lesson) but this also caused a burdensome weight gain. Please address this issue & don't say exercise that's how I got hurt the first time. I'm talking 25 lbs.
EXERCISE. but approach it much more gently. start by doing chair yoga every day. start there.
Thank you. They did a very simplified neuro exam when I was in at my neurologist for a work in appointment. Not diagnosed with anything right now. Is it a common occurrence for people in general to not be able to walk on their heals without losing their balance?
I’ve had MS for 30+ years and have never had a neuro do some of these. My main symptoms are dizziness and vertigo. Alaska is not the best place to have ms.
Another great video. I would like to know the best questions to ask neuro-ophthalmologist.
they are wizards of the eye exam. They will lead you through a series of questions to help them sort out what's going on. Just answer to the best of your ability!
@@AaronBosterMD Thank you for all the help.
I was diagnosed with MS about 3 weeks. I have struggled with balance and vertigo along with slight numbness on my left side to include the left side of my tongue. I have a moderate size lesion on the right side of my brain and some small scattered old lesions. My MS specialist told me I have no lesions on my spinal cord and cerebellum so he was surprised that I have the vertigo and balance troubles. They are my most bothersome symptoms. If a lesion on my cerebellum is not the cause what is?
Thanks for this video, Dr B. I didn't realise it's the cerebellum. My speech is apparently clearer now (saw neuro a few days ago). But my singing is terrible now, can't hold a tune at all.
glad speech is better. I wonder if working with a speech therapist would help you get your singing back...
@@AaronBosterMD right! I'm nervous to even sing at home now
Hello Dr Boster, I have had PML once before. My Dr. is gonna try me on "O". Should I be worried
What about if you can pass one of these tests one time but can't another time?
Can your test results change?.. maybe during “episodes”?
My neurologist doesn't always perform these tests and there are some you showed that I have never had. Could this be because he already knows certain things about my status and doesn't need to "beat a dead horse", or could he just not be being real thorough in his examination? Thank you for your time in posting the video and for reading/addressing my querry!
- Raymond
yes that is possible. I don't exam people in follow each visit. I often times use standardize testing (low contrast vision, nine hole peg test, timed 25 foot walk and cog screening tests) to guide me. Then I'll do a "spot" exam on systems I'm concerned about.
@@AaronBosterMD that makes sense. Thanks again!
Hi I have noticed my balance being off a couple months ago. I can’t balance with eyes closed and feet together and I can’t walk heel toe at all. I’ve been having issues with lightheaded feeling a lot the last few weeks and I also have trigeminal neuralgia. Do these sound like Ms symptoms? im a 60 year old woman. No cardiac problems
Thanks for another video on the balance and coordination Somebody threw a grenade in my cerebellum :/
Are these retrainable in some way? Is it actually worth the effort of trying to?
I’ve had some therapy years ago using a wii with balance board
Actually thinking (again) of buying one and transforming my “training room” into a “safe room” with pillows and stuff to make falling less dangerous
Howdy Kg0rz! You CAN retrain balance: th-cam.com/video/YmHOgkXfJvQ/w-d-xo.html
I started about 6 months ago, stuttering at times. How can I can it down when it starts?
some have good success working with speech therapists. I'd start there, super helpful!
lol. I got lost in the ABCs. but I'll get it.
Ha!
Hi,
Interesting video.
My balance has really suffered and I am using a wheelchair at the moment.
I noticed that my muscles really suffered after starting to use it and I have been trying to train my muscles so I could hopefully start to walk again at some point.
Is it plausible that I would regain the balance (meaning heal the part of the brain that controls it) so I could hope to start walking after some training? Have you had patients in this kind of situations
I am still very hopeful about my own situation as I am not noticing any mental issues at the moment.
Thanks for making these awesome videos.
I can't comment on your specific situation without examining you, reviewing your MRI scans, etc. To speak in generalities, it's hard but it is possible to retrain aspects of balance and coordination. Hope this helps and keep fighting Daedana!
@@AaronBosterMD Hi Doc,
Thanks for your answer, It contained the information that I hoped to get on this situation. I understand that you cannot give further advises because there is so little information here for you.
I will continue with the diet (mostly plant based) diet and exercise as recommended. On the positive side, my arms have gained some muscles because of the use of wheelchair, so it is not all bad. :)
Your comment made my day and keep making the awesome content here. I am writing this from UK, so you are getting international fans with the channel.
So happy you're finding this content and community a positive one Daedana! Where in UK, may I ask?
@@AaronBosterMD I live in Belfast in Northern Ireland at the moment. Moved here after some work.
Hmmmmm, I used to throw a mean game of darts and stopped after diagnosis had me in a chair for a while. After I regained my ability to stand and walk somewhat normally I tried throwing some darts and I could barely even hit the dartboard, much less play a game. It feels totally foreign now, either hand. I can still throw a tomahawk but that is much more gross motor movement and less detail throwing. It’s just not a good idea to throw tomahawks in the house. At least my wife doesn’t think so. I guess it keeps the paint costs down. Blessings!
I can only imagine the conversation between you and your wife, "But what if I'm really careful throwing this hatch in the house honey??!" lol. ⚔
Aaron Boster MD Uhh yup! It was very calm and collected!😂
Fail, i knew I would and after all my visits to the gym and PT I would fail your test
there's no pass or fail Debbie. Just assessments of levels of functioning. You CAN retrain with PT, don't give up Debbie!!
Aaron Boster MD I will never give up my son is severely autistic. I won’t let him down he needs me
Looks like. DUI stop lol