Question Title: Confusion

Forum: Neurology Forum
Topic: Headache

We thought my wife had a broken or bruised coccyx. She had an xray done and a doctor prescribed physical therapy for what he thought might be a disc problem. The PT seemingly just made things worse. She now has leg pain (generally in her left buttocks and back left thigh and right calf). The PT was stopped after 10 sessions and the Doctor had an MRI done. The MRI , as I understand it, shows bulging at T11/12 and L5/S1 and a tear at L5/S1. It also shows some bunching of nerves, described as arachnoiditis. Bloodwork to check for inflammation was just done and came back "high normal" which we were told could have been related to the pregnancy (though our child is almost 4 months old. She had an EMG iof her legs and ack in Jan 99 and that was normal.

She has had numbness at least once in her right calf and foot, still has low back pain (though seemingly less) and buttocks pain, but the leg pain is the most severe. She also has experienced tingling in her hands when sleeping (even when her hands and arms were not in a position that would cause numbness) and a routine eye exam in November revealed that she has developed a problem focusing her eyes at close range (which has not heretofore ever been a problem).

We are confused. Could she have arachnoiditis from the blood patch? The internist has recommended that she take a two week course of oral steroids. He thinks that this is arachnoiditis but it is "curable." A rehab doctor who looked at her charts thinks that she has arachnoiditis, says it is incurable , believes the oral steroid traetment is not a good idea, would recommend a discogram to rule out the discs as a cause of the pain & injections of steroids to attampt to alleviate pain. If it is arachnoiditis, then he would send her to a pain management specialist. Another rehab doctor (the one who did the EMG, ordered the MRI and the xray) is not so definite about the pain being from aracahnoiditis.

Everyone discounts the hand tingling (at rest) and the eye issue.
We are confused. No one has recommended that we see a neurologist. Should we? If arachnoiditis from a blood patch is exceedingly rare, could somethiing else be going on? If it is arachnoiditis, is my wife destined to be in severe pain or are there therapies (non-narcotic if possible) to assist her in living the heretofore active life she had. The current state of affairs, and fear for the future, is devastating. I am willing to go anywhere to find someone who can look at the big picture, come up with a game plan and answer the question, and put her on a path to recovery or something approaching it. I don't want us to wait too much longer for answers.

Any advice, thoughts, recommendations will be gratefully accepted.

Dear M. Nelson:

Boy, certainly what you two didn't expect in having a child. Giving advice over the internet has so many problems, I hope that you realize that without seeing the actual MRI and lab work and not having done the physical exam myself, it is impossible to tell you want is going on. With that in mind several thoughts arise. First, the changes noted on the MRI might or might not be related to the pregnancy. Since, usually during the pregnancy process the female body makes a hormone that relaxes the ligaments to accomidate the enlarging fetus. My guess is that this process was occuring before the pregnancy and that "maybe" the events during the delivery and after just worsened things. Almost everything in medicine is possible, so a blood patch could theoretically cause archnoiditis. This is not the most likely cause, but it might be. What I think you need to do, is to gather all the information, lab work, MRI, and take everything to a neurologist to have him/her evaluate the situation. A second opinion,
might give you a fresh view point and find something that everyone missed. I hope that thing work out.

Sincerely,

CCF Neuro [P] MD

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