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Neurology (Expert Forum)
Cervical bulging disks, weird symptoms
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Cervical bulging disks, weird symptoms
by Jenny Wren, Nov 19, 2006 12:00AM
I am a 35 year old female, I recently had a brain MRI w/ and w/o contrast in Apr. coz of tingling in face, upper legs, back , and arms, that seems to be worse with clothing on. In Sept I had a c-spine, and a bulging disk was found at C-3, C-4, doc says that this would explain the left sided headaches, left sided facial tingling, and left sided earache, she gave me trigger point injections, and my lower teeth and ear have not hurt since, but the tingling in face still remains. The bug crawling sensations that I used to experience is now turned to a feeling of cold water running through my veins, in arms and legs. I had a bad delivery with my son 10 years ago, and the next day my entire leg was in terrible pain, the nurse told me that sometimes they knick the sciatic nerve with the epidural, it went away after a few days. I fell in a hole in 2002, landed on my tailbone, I went to chiro, was adjusted, started burning in lower back and upper legs, just recently took a 4 mile walk and the burning came back, lasted a week, no weakness, no numbness. To date these are my symptoms: all kinds of weird sensations (bug crawling, water in veins), my left leg goes numb when I go to sleep at night on the outside from knee up, and the bug crawling sensation on my face is now replaced with stinging sensations. 1. Where is an epidural injected, I though it was higher than where the sciatic nerve is? 2. What else could this be, MS? 3. Do you think that the childbirth got this all started, and the fall put the doozy to it? What should I do, it drives me crazy these sensations. Thank U!
Doctor's Answer
by CCF-Neuro-M.D.-SH, Dec 10, 2006 12:00AM
First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes.
I have answered your posts a number of times in the past. A cervical lesion (at C3-C4) can not explain facial numbness. There are migraine headaches that are contributed to by cervical problems, but they can also be contributed by other things as well. It is encouraging that you had some relief with trigger point injections (which makes migraine headaches more likely). As I have mentioned in the past, the most likely explainations for your symptoms is migraine headaches (with the "weird" symptoms related to central sensitization), followed by multiple scelrosis and/or psychiatric manifestations. Although, I think MS is unlikely, I would recommend that you have a complete MS workup to rule out this treatable condition. I know that you have had some MRIs in the past, but they should be repeated if they were not done to specifically look for MS. Your MRI of the brain and cervical spine should be done with GAD contrast and a MS protocol (that includes a saggital FLAIR). You should also have visual evoked potentials and somatosensory evoked potentials to assess if demyelination has occured in your optic/spinal system (MS causes demyelination). Finally, a lumbar puncture should be done (spinal tap) to examine your CSF for signs of inflammation (tourtelotte, IgG index, oligoclonal bands). For the migraine headaches taking a preventative medication (Elavil, topamasx, nadolol, etc) is the best strategy when "weird" symptoms are involved, and trigger point injections with marcaine/kenalog and/or botox are also very effective. The epidural does not enter the spine itself and only tracks along the outer coverings of the spine to provide nerve blocking agents. The sciatic is more likely to be injured in the positioning of your pelvis in labor and/or stretch/manipulation during delivery. This is unlikely to be related to your current symptoms.
I hope this has been helpful.
I have answered your posts a number of times in the past. A cervical lesion (at C3-C4) can not explain facial numbness. There are migraine headaches that are contributed to by cervical problems, but they can also be contributed by other things as well. It is encouraging that you had some relief with trigger point injections (which makes migraine headaches more likely). As I have mentioned in the past, the most likely explainations for your symptoms is migraine headaches (with the "weird" symptoms related to central sensitization), followed by multiple scelrosis and/or psychiatric manifestations. Although, I think MS is unlikely, I would recommend that you have a complete MS workup to rule out this treatable condition. I know that you have had some MRIs in the past, but they should be repeated if they were not done to specifically look for MS. Your MRI of the brain and cervical spine should be done with GAD contrast and a MS protocol (that includes a saggital FLAIR). You should also have visual evoked potentials and somatosensory evoked potentials to assess if demyelination has occured in your optic/spinal system (MS causes demyelination). Finally, a lumbar puncture should be done (spinal tap) to examine your CSF for signs of inflammation (tourtelotte, IgG index, oligoclonal bands). For the migraine headaches taking a preventative medication (Elavil, topamasx, nadolol, etc) is the best strategy when "weird" symptoms are involved, and trigger point injections with marcaine/kenalog and/or botox are also very effective. The epidural does not enter the spine itself and only tracks along the outer coverings of the spine to provide nerve blocking agents. The sciatic is more likely to be injured in the positioning of your pelvis in labor and/or stretch/manipulation during delivery. This is unlikely to be related to your current symptoms.
I hope this has been helpful.
Did your doctor give any explanations about the C3-4 causing facial symptoms?? Because I thought our nervous system didn't go backwards (from neck to face, a lesion on the neck would cause symptoms toward your feet, not towards your head).
This was what I learned at vet school, and what at least 3 doctors told me (I saw this online and asked, they laughed at me).
Hope we can find answers to our questions (and prays).
Good luck
rcs2
Since then my hand hasn't gone numb, but my cheek has had that tingling many times. At first I thought maybe I did have a TIA