I'm not looking for medical advice, since my brother is already under the care of a doctor, just trying to understand the rationale for the diagnostic tests that have (and have not) been ordered.
My brother is 46, and in very good physical condition. He's an avid golfer and runner, and works out with weights regularly. About 2 weeks ago, he got up from a chair and fell to the floor because he could not feel his foot. It was twisted at the ankle, and not placed flat on the floor. He then realized that he had significant numbness and tingling in the foot, and could not feel its position as he walked. Without actually watching his foot, he can't walk properly because his foot "flops". OK, sounds like foot-drop to me. Off to the doctor.
It took him a week to get into his PCP, who agreed that a neuro referral was in order. The PCP ordered routine yearly labwork (CBC, chemistries, lipid profile, thyroid, etc.) but deferred any imaging studies to the neurologist.
It took another week to get into the neurologist who examined him, verified that he likely has nerve impingement, and ordered only a nerve conduction test, stating that it was necessary to determine the cause of the impingement before deciding on a course of treatment.
That's where I get lost. I understand that a nerve conduction test will give information regarding the degree of nerve damage, but don't understand how it will shed light on the CAUSE of the impingement. (The neurologist suggested arthritis vs bulging disc as possible causes.) My concern is that he can't get the test done until mid-May, a full month from now, and 6 weeks from the onset of symptoms. It seems to me that they should do an MRI in the meantime, and I have asked my brother to call the neurologist back and ask about this. I'm concerned that they will wait so long to diagnose this problem that his foot drop may become permanent, and am also concerned that he will fall and really hurt himself in the meantime.
Any thoughts or suggestions? Any insight as to why an MRI has not been ordered? He has "traditional" insurance which allows him to see virtually any doctor and use almost any facility he chooses.