Hoover's Babinski ???? Can someone tell me what's the truth?

[SunshineDaydreams]

I have had pain and fatigue for years with occassional limping and cognitive difficulties - since April, have had all that amplified and tingling/numb, weakness, a LOT of cognitive problems, o-bands, high IgG, positive Glycominds, and six 'small' lesions in brain.

I was dx with MS in June. I got a second opinion, also dx with MS, but this one stated he doubts my symptoms are caused by MS because of absence of the Hoover's sign ...?

I went to another neuro - said she doesn't think it's MS because I lack Babinski's sign ...? This one really amuses me because she didn't even take my shoes off during the exam...?

Can someone explain to me how I can be lacking these signs the neurologists are looking for, but still meet the McDonald criteria for MS. I am really having a hard time just getting through my days at home - was told yesterday I need a $7,000 power chair to do anything outside of my home - yet these doctors don't want to help me because I'm not showing them the signs they want?

Would my herbs cause me to not have these? I take valerian root almost daily for spastic muscles (herbal tranquilizer/nervine) - lemon balm and skullcap (nervines) as general nerve tonic - hawthorn berry for circulation.

I'm really confused and looking for another neuro now, but I need to understand what these guys are talking about.

[22cyclist]

1. Hoovers sign tests for organic leg weakness. If you do not have this sign then your leg is not weak organically, meaning not by a disease.

2. Babinski reflex is when they scrape the bottom of your foot with the end of the hammer or whatever they have and your big toe goes up, and little toes fan out. This is a reflex, you can't fake it, if your toes go down, which is normal, you have no CNS disease. At least not at this point.

This is a good neurological exam.

3. Who told you you needed a power chair, and who is giving the prescription for it? If this neurologist is writing the prescription for a power chair then he is questionable. Otherwise why not start with an assist device? Did a physical therapist tell you this? They can't order it without a prescription.

4. Obviously this neurologist does not feel you meet the criteria at this point. But this is a good thing. It seems he is pretty reputable.

I know you are irritated, but don't run away so fast. Give this MS specialist a chance to take care of you. I mean the guy spent 3 hours with you. He doesn't want to diagnose you willy nilly. Ask him about the power chair, or at least a cane. OK? If you want to still do things. Perhaps physical therapy on an ongoing basis.

[Whimpurr]

IF you do not have the Babiniski reflex, you said you cannot have and CNS disease???

[22cyclist]

Generally you do not.

[SNOOPY]

IF you do not have the Babiniski reflex, you said you cannot have and CNS disease???

The Babinski Reflex is part of a diagnostic aid. When abnormal, it indicates damage to the Central Nervous System (CNS). MS is a disease of the CNS.

As 22cyclist stated, you cannot fake the reflex response. Babies have an abnormal babinski but for them it is normal.

http://www.medterms.com/script/main/...rticlekey=7185

[Whimpurr]

Yes, I am aware of what the Babinski is and was it normal vs. positive / negative. I have also read though that you can have a negative babinski but still have MS.
Just wanting to clarify that because we have to be careful making blanket statements.

[SunshineDaydreams]

Are we making generalizations about the Babinski? If toes go up on some exams and down on others, but big toe goes up and others spread out ALWAYS on standing on tiptoe on that foot - what is the result of that test when this is the reality? And how can you tell any of this with SHOES ON?

How can I be negative MS with 12 year history, lesion in 2001, optic neuritis in 2001, O-bands in CNS, high IgG, positive Glycominds, and verified MS lesions?

Who spent 3 hours with me? NOT ONE NEURO - all of these exams were done in a matter of 30 seconds each - no real time spent at all.

The power chair was ordered by my GP who has known and treated me for over 25 years - she knows this is MS, but can't formally dx it being a GP. She sent me to the GP in the system who dxd me and then disappeared. He is now signing off on the wheelchair order.

I went through a formal eval in physical therapy at the hospital where I used to work and my PCP and this neuro are. I've been on a cane, even though I was told to get a rollator walker, for the last 6 months. I've had two attacks since then and gotten worse with each one. My PT therapist told me she can't do anything else for me because I've reached another plateau and this is the best I'll get. Every person I see there tells me I'm only going to get worse. They referred me to the local MS Society branch who are coming to my home to evaluate what changes need to be made to my home.

I've lost my home, my car, and most of my friends. If I now lost my disability payments when I spend half of my time barely able to walk or talk and had to get a power of attorney to sign off on my bills and any big decisions about my home - what am I going to do?

[22cyclist]

Whoa! Sunshine-im sorry

I confused you with someone else! I was moderating and you and anther OP had very similar stories. I AM SO SORRY! As far as the power chair goes, can you still get it?

I can understand your frustration. So the doctor did not check your plantar reflexes (babinski sign) at all? You had your shoes on the whole time? That would really make me mad. It happened to me once my neurologist (a really good one, wrote that my tongue protruded midline, which it can't anymore, it goes out to the side due to a pontine lesion, but she didn't even look in my mouth and it really made me mad!), so I understand now why you are so irritated!

Now, since you are not diagnosed, or are undiagnosed now, can you go back to the first neurologist, or have your PCP find them for you to straighten all of this out for you?

[SunshineDaydreams]

It's ok 22 cyclist - I love you

No, I AM dx - twice. The original neuro at the hospital dx me and the Hoover's sign MS specialist dx me - then said I don't have Hoover's sign so sx are not MS ...???? Talk about confused?

Yes, the Babinski girl - she did irritate me big time! How can you even begin to test Babinski with shoes on? I don't know if what is going on with me is technically Babinski?

BUT - I am pretty sure the Hoover's sign was not tested correctly. He had me sitting on the table and put a hand under my upper thigh (very uncomfortable btw) and had me lift the opposite leg - I'm over 200 lb btw. I don't think this was even correct - and then they note this stuff in my records ?

As far as I know - as much as I don't want it - yes, I am getting the power chair :/

[Whimpurr]

It's ok 22 cyclist - I love you

No, I AM dx - twice. The original neuro at the hospital dx me and the Hoover's sign MS specialist dx me - then said I don't have Hoover's sign so sx are not MS ...???? Talk about confused?

Yes, the Babinski girl - she did irritate me big time! How can you even begin to test Babinski with shoes on? I don't know if what is going on with me is technically Babinski?

BUT - I am pretty sure the Hoover's sign was not tested correctly. He had me sitting on the table and put a hand under my upper thigh (very uncomfortable btw) and had me lift the opposite leg - I'm over 200 lb btw. I don't think this was even correct - and then they note this stuff in my records ?

As far as I know - as much as I don't want it - yes, I am getting the power chair :/

I am no expert at any of this and am still in limboland myself! I understand that we ALL are frustrated ... even those of us with diagnosis! MS is a darned frustrating disease! (((HUGS)))

[onlyairfare]

My understanding is that the diagnosis of MS is based on McDonald criteria, which basically confirm that you have CNS lesions separated in time and space, and not explained by another diagnosis besides MS. The criteria do not say anything about "you MUST have Babinski or Hoover's sign." Babinski is an abnormal motor neuron reflex.
If your MS diagnosis is based on sensory symptoms or optic neuritis or any of the many other manifestations of MS, it is quite possible to have MS but no Babinski sign. Or no Hoover's sign.

So how could a neuro say that you don't have MS anymore, or you are now "un-diagnosed," just because a single sign is absent? I think I am confused too!

OP, do you think that neuro was saying that your leg weakness was due to some cause other than MS, even though you do have MS? Unfortunately there is no law that we can have only one disease at a time.

For example, MS patients have more seizures than people who do not have MS. I had a seizure and I have MS. But it was an unrelated brain tumor that caused my seizure, not MS. Maybe your limp is because of a pulled muscle or something else instead of MS, but that would not mean that you don't have MS.

Anyway, I hope you get this straightened out, as it must indeed be very frustrating.

[22cyclist]

It's ok 22 cyclist - I love you

No, I AM dx - twice. The original neuro at the hospital dx me and the Hoover's sign MS specialist dx me - then said I don't have Hoover's sign so sx are not MS ...???? Talk about confused?

Yes, the Babinski girl - she did irritate me big time! How can you even begin to test Babinski with shoes on? I don't know if what is going on with me is technically Babinski?

BUT - I am pretty sure the Hoover's sign was not tested correctly. He had me sitting on the table and put a hand under my upper thigh (very uncomfortable btw) and had me lift the opposite leg - I'm over 200 lb btw. I don't think this was even correct - and then they note this stuff in my records ?

As far as I know - as much as I don't want it - yes, I am getting the power chair :/

The Hoovers test was done right. The babinski with the shoes on (or should is say the non-test) LOL! NOT SO MUCH! As for the power chair, I know it is hard, I had to get a scooter, at first it is difficult, but you get used to it. Pretty soon you don't think about it as much, its just an everyday appendage.

Hope it goes well for you.

Lisa