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Chronic Microvascular Ischemic Disease
Stroke & Cerebrovascular Diseases | Last Active: Sep 13 11:55pm | Replies (54)Comment receiving replies
Dr. Scott Speelziek, M.D. ( The good Dr. is a very pleasant person) No evidence of acute infarct or new significant changes in small-vessel disease. Not sure if this is good or bad news?
"He does have hyperreflexia most notable at the bilateral patella where there are crossed adductor signs and +2 reflexes bilaterally. In the upper extremities, I would grade his reflexes at +2 on the left and +1 on the right negative Hoffmann sign"
The exam is suggestive of perhaps a spinal cord pathology in the low cervical or upper thoracic spinal cord.
My hyperreflexia as well as evolving paresthesias or numbness and balance issues would raise a suspicion for pathology there either in terms of intrinsic cord inflammation, which is relative
An MRI of the cervical spine. to evaluate for any potential pathology involving the cervical spine. additional testing including potentially EMG could be pursued.
As far as the Mayo Clinic Tapestry Study people are randomly offered to ask to participate. The good Dr. said felt like it was more of a business decision with help from Helix genomics company to compete with 23andMe and other DNA test kit companies.
Replies to "Dr. Scott Speelziek, M.D. ( The good Dr. is a very pleasant person) No evidence of..."
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Overall I would view this as good news. No acute infarct means no evidence of a stroke, and no new changes in the SVD means that it isn't progressing significantly. I also have chronic micro vascular disease and can empathize with you.
I think that the normal for reflexes is +2, and a negative Hoffman sign is also good.
An MRI is a painless way to see if you have any nerve compression that could cause your paresthesia.. It could be something as simple as a pinched nerve or slipped disc. I have had both cervical and lumbar fusions (and a lumbar discectomy) due to injuries. The cervical surgery was not that bad and if necessary don't worry about it. I have had 2 EMG's due to ulnar nerve damage and they are not fun.
Just follow your doctor's recommendations. If your symptoms are an issue you can choose to have further testing to see if there is a course of action that you may benefit from.
Good luck!