Navigating Long-Standing Challenges with Attention and Coordination: Seeking Specialist Guidance
Hello r/AskDocs — I'm reaching out for concrete medical guidance regarding my next steps and which specialists I should consult in light of my persistent symptoms and recent MRI/EEG findings. **Age:** 30 **Brief Overview of My Situation:** I have grappled with various issues since childhood, including: - **Attention and Memory:** I've consistently faced challenges related to focus and working memory, particularly struggling to encode both written and verbal information. This often leads to losing track during conversations or following instructions. - **Spatial Awareness:** I tend to get turned around easily, having difficulty memorizing routes, even in areas I know well. - **Coordination and Motor Skills:** Since I was young, I have experienced awkwardness when gripping pens and utensils, clumsiness in movement, subpar performance in sports, and trouble mastering basic motor skills, such as repeating simple gym stretches. - **Sleep Issues:** I occasionally engage in sleep talking and walking, and I suspect my sleep is disjointed and unrefreshing. **Previous Evaluations and Treatments:** I underwent a neuropsychological evaluation geared towards ADHD, but the results were negative. I also tried stimulant medications under medical supervision, which yielded no significant benefits. Recent lab tests indicated normal vitamin D levels but an elevated B12, which I've since ceased supplementing. **Recent Diagnostic Tests:** I had an MRI of the brain and an EEG conducted recently. The MRI report identified a cyst or lesion, which has remained stable upon follow-up scans. The EEG results came back normal. **Questions for Healthcare Professionals:** Given my long-standing multi-faceted symptoms and the MRI's indication of a cyst/lesion, which specialists would you recommend I consult, and what order should I prioritize these appointments? Are there any additional diagnostic tests that you suggest I request to better understand the MRI findings and my symptoms? Furthermore, could this solitary structural lesion or cyst reasonably account for the lifelong developmental challenges I've faced, including those related to attention, working memory, and motor skills? Or would these symptoms more commonly hint at an inherent developmental or genetic cause, separate from any lesion acquired later in life? In practical terms, if you were managing this case in a public clinic, what would be your first steps? Would you recommend an immediate consultation with neurology or neurosurgery regarding the MRI, a sleep study, comprehensive neuropsychological testing, or assessments in audiology or vision? Please provide specifics on the order in which to pursue referrals or tests. I appreciate any insights or suggestions you can share.
Answers (1)
2/5/2026, 1:10:43 PM
OpenHealth AI
Thank you for sharing your detailed situation. It sounds like you’re managing a complex set of challenges, and it’s completely understandable to seek clarity on the next steps and specialist referrals. Here’s a structured approach to help you navigate your concerns:
Main Points
- Consult Appropriate Specialists: Seek out neurology and possibly psychology specialists.
- Consider Additional Diagnostic Tests: A sleep study and further neuropsychological testing may provide insights.
- Understand the MRI Findings: While a cyst/lesion could influence symptoms, developmental challenges often arise from a combination of factors.
Explanation
Your symptoms suggest a multi-faceted challenge that could stem from both structural brain findings (like the lesion) and potential developmental issues. The cyst you mentioned might not be the sole reason for your lifelong problems with attention, coordination, and memory, as these can often have genetic or developmental roots. Therefore, evaluating both domains—neurological and psychological—will provide a more comprehensive understanding.
Next Steps
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Neurology Consultation:
- Priority: Schedule an appointment with a neurologist first. They can further assess the MRI results, discuss the cyst in detail, and determine whether it necessitates any intervention or monitoring.
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Comprehensive Neuropsychological Testing:
- Next Step: After your neurology appointment, consider a more thorough neuropsychological evaluation. This can help differentiate between neurological impacts and cognitive developmental challenges.
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Sleep Study (Polysomnography):
- If sleep issues continue to affect your quality of life, pursue a sleep study next. A sleep disorder could aggravate cognitive and motor issues.
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Consider Additional Referrals:
- If your neurological consultation indicates normal findings, you might want to explore referrals in audiology or occupational therapy, especially for motor skills assessment.
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Follow-Up and Monitoring:
- After obtaining initial evaluations, ensure you discuss any further tests or follow-up scans related to the cyst with your neurologist, helping manage any emerging concerns.
Summary
In summary, prioritize visiting a neurologist first to discuss your MRI and its implications. Then, consider neuropsychological testing to assess cognitive aspects, followed by a sleep study if needed. This structured approach should help you get a clearer picture of your situation and lead to effective management strategies. Let me know if you have more questions or need further elaboration on any point!
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