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Neurology (Expert Forum)
stinging in right leg only
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stinging in right leg only
by shferolie, Jan 27, 2007 12:00AM
I have spinal stenosis in both my cervical and lumbar spine. (congential) At c5 i have a myleomalacia that seems to be stable according to my last 3 mri's(each january 1 year apart)My lumbar spine is only seems to be symptomatic after a lot of walking and always goes away with rest. My cervical stenosis started causing problems a year and a half ago with tingling and numbness when i bend my neck back and reach for things but it goes away when i sit straight. Last August I started getting a burning/stinging feeling in my right leg that gets worse at night and is sometimes unbearable. There is always a little numbness with it that also gets worse at night. I can't pinpoint whether the burning gets worse when i move my neck but sometimes when I tip my head back there seems to be a warm sensation in my lower extrematies that goes away when i straighten up my neck. this is separate from the burning. Ususally when i wake up and start moving around in the morning it gets a little better but never goes away. I have a neurologist saying it can't be from my cervical spine, a DO from the spine clinic (non-surgical) saying it's from cervical spine and another neurologist saying it could be from both but there's no way to tell. I see a spine surgeon and he wants to do a laminoplasty from c2-c6 which i have scheduled for the end of March because he believes it is my cervical spine and it's progressing even though mri does not show. Is there a specific test to be able to tell just where the sensation is coming from? Does it sound possible that it would be coming from my cervical spine?
Doctor's Answer
by CCF-Neuro-M.D.-SH, Feb 19, 2007 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.
The symptoms and story that you provide is consistent with cervical canal stenosis, but should be investigated further with some tests. A somatosenosory evoked potential (SSEP) test can investigate the 'wires' connecting your leg to your brain to assess for dysfunction from your possible cervical myelopathy. Sometimes a functional disturbance can be found with an SSEP, even when the MRI seems unchanged. I would also recommend an EMG of the right lower extremity (if not already done). This will help localize the disturbance in your leg to the nerves, muscles or spine. It is less likely that your lumbar canal stenosis is causing the pain in your leg at night (lumbar canal stenosis mostly causes pain with walking, and improves with rest). From the symptoms that you describe, it is likely that you may need surgery, but I would complete all the tests to be as informed as possible prior to any possible operation.
I hope this has been helpful.
The symptoms and story that you provide is consistent with cervical canal stenosis, but should be investigated further with some tests. A somatosenosory evoked potential (SSEP) test can investigate the 'wires' connecting your leg to your brain to assess for dysfunction from your possible cervical myelopathy. Sometimes a functional disturbance can be found with an SSEP, even when the MRI seems unchanged. I would also recommend an EMG of the right lower extremity (if not already done). This will help localize the disturbance in your leg to the nerves, muscles or spine. It is less likely that your lumbar canal stenosis is causing the pain in your leg at night (lumbar canal stenosis mostly causes pain with walking, and improves with rest). From the symptoms that you describe, it is likely that you may need surgery, but I would complete all the tests to be as informed as possible prior to any possible operation.
I hope this has been helpful.