1st neuro appt tomorrow - what to expect?

[babyatlas]

for the past few months i have been very forgetful, cannot find the right words, feel like i am withdrawing socially and just have fuzzy thinking.  i often find myself staring off into space - my mind is still engaged and i can think "i am staring off into space" but it requires an effort to get my eyes/mind to stop it.  somedays, about 2 days a week (like today) i just don't feel right in my skin.  i can control my body but it feels like i have to actually think about it to do it (that might not make any sense).  so i had an MRI done last month and there were "small areas of non-specific white matter" on my brain.  i have no idea what this means or could mean.  i have read various things online and have worried myself sick thinking about the variety of diseases i could have - my greatest fear being early onset alzheimers.  my doctor set me up with a neuro who i am seeing tomorrow.  
so what do they do at a neuro appointment?  will she review my MRI with me?  what do i ask, say, expect.....i am nervous and afraid of what she might tell me.
thanks for any words, advice, support, etc.
most sincerely,  R

[sllowe]

Hi R,

Adding on a belated welcome, and glad you are feeling better now about your appt.  

Let us know how you make out.

Thanks for joining us,
-Shell

[babyatlas]

a very sincere thank you for a detailed response.  this is what i wanted to know and needed to know.  

i am 38 and i don't know anything about my MRI except there is the presence of non-specific white matter.  i don't know where it is or how big it is except my primary doctor said "small" but i don't know what that means exactly or how many spots there are.  i have never had a migraine - mild headaches once in awhile - more often in the last 6 months - but not migraines.  i also have never had high blood pressure and i see my primary doctor regularly.

thank you also for letting me know not to expect answers tomorrow.  i realize this might take awhile (especially after reading other posts here detailing years of searching).  i am already scheduled to see a psychologist and am glad you mentioned the neuropsychological/psychiatric testing as the mere mention would have concerned me.

again, thank you for helping me get through the day and giving me valuable information for my appointment tomorrow.

most sincerely,
R

[Quixotic1]

Hi, and welcome to the forum.  I see that you have come here mostly with fears that you have a disease of degeneration of the brain.

First, you are getting ahead of yourself with the worry.  There are many things that can cause cognitive slowing and the episodes you are suffering and many are treatable and far more common than Alzheimers or MS.  Right off the bat I would want to see you tested for vitamin deficiency, thyroid disease, depression, unusual seizures, sleep disorders, small strokes and a few other things.  The episodes you describe could be as simple as low blood sugar.

Early-Onset Alzheimers, to my understanding is a clearly genetic disease.  If there is no history of such a thing in your family, then this would be VERY unlikely.  The rare spontaneous mutation is too unlikely to even be considering.

Your MRI shows small white matter lesions which don't show any particular pattern that would indicate that they were caused by MS or something else.  This is hard to talk about without knowing a lot more about you.  Such lesions can be caused in a younger person (less than 40) by untreated high blood pressure and by migraines just to name the two most common.

This would be an uncommon presentation of MS - not impossible, uncommon.

The neuro should take a detailed history of your symptoms, your family history and do a very thorough and detailed neuro exam.  The neuro exam covers you head to toe and should involve many dozens of quick little tests of eyes, facial movements, skin and touch sensitivity, tendon reflexes, muscle strength, coordination and balance, gait and given that your problems are with your thinking (s)he will likely do some quick testing of memory and reasoning.

Yes, we expect our neurologists to read the MRIs themselves and we all think it is best if they review the positive parts with us, though not all do.

You may very well not have answers tomorrow.  Likely the neuro will order some testing based on what seems the most likely causes of the things you are suffering.  Do not be surprised if neuropsychological testing or psychiatric testing is also ordered.  Neither of these would mean the neuro thinks you're crazy.  They are all part of determining the cause when someone comes in with complaints like yours.

Alzheimers has been in the news a lot.  If this is what you fear then ask the doctor straight out.  I do not suggest that you explain that you have been reading a lot online.  Many doctors are annoyed by this - called "symptom surfing" - and they get off track.

If you often have severe anxiety about your health, this should be discussed also.  Sometimes treating anxiety is the only way to know which symptoms are produced or heightened by the anxiety and which aren't.  If you don't usually have anxiety over health issues, you should mention this also.  Anxiety is often blamed when it shouldn't be.

I hope this has helped and that other people come by with their welcomes and thoughts.

Quix