Aaron Hartman, MD explains how to spot neuroinflammation at the bedside. A tremor shows up when you place paper on a patient's hand. He also describes abnormal reflexes, pupils that re-dilate as if sensing danger, and weakness in balance and core muscles.
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One thing that I've used to see for years before that I didn't quite know as a marker for neuroinflammation, is a fine tremor. Some people's tremors so fine you have to put a little piece of paper on their hand and you'll see the paper kind of shake. Sometimes you'll see abnormalities and reflexes. One of the things I've noticed is actually part of the sores of my dysautonomic patients is what I call an adrenal pupil. Where you'll be shining a light in their eyeball and it'll constrict down. But then that's their sympathetic. So that's their parasympathetic vasoconstriction. But then there's sympathetic fight or flights like this is dangerous. And goes back open. You can actually see the pupil struggle. Is this a safe place or is it a dangerous place? And all of a sudden this person's neurological system is. They have a mild, at least a mild form of dysautonomia. There's other differences you can do between your. Your muscles of balance. When you do a physical exam. When you do a really good neurological exam, you can actually pick up on their. Some of their core muscles with the weakness, like an imbalance in their body.