International ME/CFS and FM Awareness Day Is On May 12, 2018
Thomas Hennessy, Jr., selected May 12th to be our international awareness day back in 1992. He knew that May 12th had also been the birthday of Florence Nightingale. She was the English army nurse who helped to found the Red Cross as well as the first school of nursing in the world.
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cervical spine-positive babinski

Discussion in 'General ME/CFS Discussion' started by xrayspex, Jan 26, 2018.

  1. xrayspex

    xrayspex Senior Member

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    Hi--I had some spinal trauma before cfs onset and it has been hard over the years to distinguish what might be primary. At any rate it has just come to my attention that if one has a positive babinski related to neck issues one might want to make strongly consider neurosurgery as sometimes permanent spinal damage can occur or worsen.

    does anyone have experience and thoughts with this from own injury or as an expert? I am going to followup with a consult but am a bit miffed as I have had a positive babinski for at least 16 years or longer. No one really sat me down and explained that is associated with upper motor neuron disorders. I know it shows with MS sometimes too but it doesn't seem I have that.

    thanks any thoughts appreciated
     
    Last edited: Jan 26, 2018
  2. PatJ

    PatJ Forum Support Assistant

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    For those who are curious about the Babinski Sign (Plantar Reflex) Wikipedia has an explanation and diagram.

    This thread on a student doctor network discusses how the positive Babinksi Sign on its own shouldn't necessarily be taken as a sign of a problem.

    This is an interesting quote from that thread:
    It's still advisable to talk to your doctor.
     
  3. xrayspex

    xrayspex Senior Member

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    thanks PatJ, I did do some research. It looked like it was usually rated more reliable than the first line motor tests some doc might do like squeeze the fingers etc It appears per usual the experts have different opinions so I figured I would reach out on forums like here and see what folk's experiences have been.
    Someone else mentioned on your thread you have to look at the complete picture:

    "We can bicker about the use of the Babinski sign, but I think this makes rather than detracts from the thread's overall point. (It's an important point along a line.) An expert will weigh the historical context and setting appropriately and look hard for features that support or detract from the overall clinical impression. There's an important interplay between the history and the exam, with one informing the other. Getting a history of 6 months of cognitive problems in 70 yo who's screening cog test of 5/30 requires you getting a better history."

    I didn't go into my long spinal woe history in my initial post but I have considered a laminectomy and a fusion in the past and am revisiting idea after was told by a rehab person ( who has had the surgery herself) that with my mri's and history and current symptoms a positive babinski almost most certainly could mean some spinal cord damage and surgery could be a way to prevent further damage--I was just a bit flummoxed because I hadn't realized that quite in same way before. But I hear you- it is not necessarily definitive-the babinksi, in and of itself. I am also pretty sure that the test was done accurately as the first time I remember having it years ago it was done by a neurosurgeon, recently I have only had 2 independent but very professionally trained PTs both elicit it on different days.

    So far I have been told recently that given my complete clinical picture---history, mri's, and other signs like hyper-reflexia, that it likely is correlated with probably myelopathy compressive issues and this would make the babinski more significant. My most troubling historical symptoms have been related to c-spine and initially I thought that was the cause of other problems that were emerging like CFS-like ones and eventually auto-immune. Over time I got confused about what was primary.....but it seems the neck is at least one of the primary diagnoses as I can do things like go for a nice walk but not look up at the sky ( cervical stenosis can make that painful and get weird neuro symptoms in my case if extend neck). I do wonder again now though if chronic inflammation from a spinal cord injury could also cause central sensitization and perhaps even auto-immune issues. I do have a history of spinal trauma as well as head trauma and recently had accident before xmas with another hit to the head that aggravated head and neck. It is finally calming down some.

    I plan to consult with an osteopath soon who was originally trained as a regular rehab doctor but went back to school and retrained self and went into private practice because he became so disillusioned with the state of mainstream healthcare in US--ie not allotting sufficient time getting histories, an inadequate array of healthy modalities to help people heal etc I figure he will have a conservative view of surgery etc but will also be able to say when it seems like appropriate action. Then I will get a couple updated neurosurgical consults.

    I have been cautious about doing invasive treatment ie surgery over the years though because of not knowing how much maybe some other poorly understood problem such as CFS is also a factor and would complicate recovery. AT the very least I do know I am genetically sensitive to a lot of chemicals and experience shows do better to avoid physical traumas so want to try to weigh out shot at better functioning vs worse if decide to do it....million dollar mystery question.
     
    Last edited: Jan 27, 2018

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