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Neurology (Expert Forum)
Cervical Herniation, Later Followed by Laundry-List of Undiagnosed Neurological Symptoms
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Cervical Herniation, Later Followed by Laundry-List of Undiagnosed Neurological Symptoms
by monarog, Feb 13, 2007 12:00AM
45 yo female, previously healthy and active, running 20-30 miles weekly.
-Sept 2005-Spontaneous C6-7 disc rupture. MRI:"C6-7 a right paracentral to foraminal disc herniation with an extruded component extending along base of right foramina with mass effect on exiting right C7 nerve root."
-Mar 2006-Bottoms both feet slightly numb,slightly off-balance,twitching,neck pain.
-Apr 2006-Go to ER -2"spells"-have to concentrate to place feet to walk,dizzy,neck pain. MRI's Cervical,"Midline posterior C6-7 protrustion with mild AP narrowing, though improved from Sept. 2005 image." Thoracic,okay. Lumbar,"Posterior disc bulges noted at L5/S1 and L4/5-no apparent neural impingement." Reflexes very hyper in ER.Since ER visit twitching, buzzing, numbness,vertigo,"rocky boat" feelings, bottoms of feet sensitive. Tongue went numb for 1 week-now often irritated with burning mouth syndrome symptoms. 3 times for 2 hours had unilateral facial numbness across cheeks and nose. Pain returns to arm. Bloodwork-thyroid,vitamin,lyme etc.,brain MRI,spinal tap,EMG/NVC-all normal.
-Feb 2007-2nd brain MRI-normal. Cerv MRI,"Increased size of C6-7 posterior protrusion; there is now an element of right-sided extrusion and increase in right cord flattening." Still have symptoms,changing literally hourly. Experienced Raynaud's Phenomenon in both hands of middle and ring fingers twice. Sudden development of high BP and have never had high BP in my life. Reflexes still brisk. Worst symptom-like my nervous system will not shut off, hypersensitive - sometimes causes hands &/or legs to tremor. Thanks.
-Sept 2005-Spontaneous C6-7 disc rupture. MRI:"C6-7 a right paracentral to foraminal disc herniation with an extruded component extending along base of right foramina with mass effect on exiting right C7 nerve root."
-Mar 2006-Bottoms both feet slightly numb,slightly off-balance,twitching,neck pain.
-Apr 2006-Go to ER -2"spells"-have to concentrate to place feet to walk,dizzy,neck pain. MRI's Cervical,"Midline posterior C6-7 protrustion with mild AP narrowing, though improved from Sept. 2005 image." Thoracic,okay. Lumbar,"Posterior disc bulges noted at L5/S1 and L4/5-no apparent neural impingement." Reflexes very hyper in ER.Since ER visit twitching, buzzing, numbness,vertigo,"rocky boat" feelings, bottoms of feet sensitive. Tongue went numb for 1 week-now often irritated with burning mouth syndrome symptoms. 3 times for 2 hours had unilateral facial numbness across cheeks and nose. Pain returns to arm. Bloodwork-thyroid,vitamin,lyme etc.,brain MRI,spinal tap,EMG/NVC-all normal.
-Feb 2007-2nd brain MRI-normal. Cerv MRI,"Increased size of C6-7 posterior protrusion; there is now an element of right-sided extrusion and increase in right cord flattening." Still have symptoms,changing literally hourly. Experienced Raynaud's Phenomenon in both hands of middle and ring fingers twice. Sudden development of high BP and have never had high BP in my life. Reflexes still brisk. Worst symptom-like my nervous system will not shut off, hypersensitive - sometimes causes hands &/or legs to tremor. Thanks.
Doctor's Answer
by CCF-Neuro-M.D.-SH, Feb 22, 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 present is complex and there is much data that I do not have. It sounds pretty clear that you have some disc disease in your cervical spine (which may explain your hyperreflexia), but some of the symptoms that you describe could not be caused by a lesion in the cervical spine (such as tongue numbness, 'spells' with difficulty concentrating, vertigo). The history that you describe is similar to a history found with patients suffering form multiple sclerosis (MS), but your 2 normal brain MRI's and normal lumbar puncture would suggest that you do not have MS. Given the 'spells' that you describe, I would suggest an EEG (electroencephalogram-'brain wave test') to evaluate for possible seizure activity. I would also suggest a somatosensory evoked potential (SSEP) to evaluate the 'wiring' in your cervical spine, to see if any signal are getting lost/disturbed by that cervical disc. I would also suggest that you take your case to an academic neurology department to have some 'fresh eyes' look at all the data that has been collected thus far. I would be a tragedy to miss a potentially treatable condition.
I hope this has been helpful.
The symptoms and story that you present is complex and there is much data that I do not have. It sounds pretty clear that you have some disc disease in your cervical spine (which may explain your hyperreflexia), but some of the symptoms that you describe could not be caused by a lesion in the cervical spine (such as tongue numbness, 'spells' with difficulty concentrating, vertigo). The history that you describe is similar to a history found with patients suffering form multiple sclerosis (MS), but your 2 normal brain MRI's and normal lumbar puncture would suggest that you do not have MS. Given the 'spells' that you describe, I would suggest an EEG (electroencephalogram-'brain wave test') to evaluate for possible seizure activity. I would also suggest a somatosensory evoked potential (SSEP) to evaluate the 'wiring' in your cervical spine, to see if any signal are getting lost/disturbed by that cervical disc. I would also suggest that you take your case to an academic neurology department to have some 'fresh eyes' look at all the data that has been collected thus far. I would be a tragedy to miss a potentially treatable condition.
I hope this has been helpful.
You have verbalized my worst fear, that this is my new life with no help or answers. As you said, I may never know - but, my biggest fear is that I won't get any relief from the symptoms regardless of why it's happening. My symptoms are mostly sensory as well, with an ocassional episode of awkward walking. It all waxes and wanes so much I never know what my issue will be, but it's always something. I am going to see another neurologist next week though don't expect much help. I am apprx one year into all of this. Have you found any RX or anything to help keep your symptoms under control? Thanks for your input.
Monarog and Patsy10 although I have not had surgery yet, but I continuously describe my medical problems as “Nothing is ever the same, there is always something new.” This worried me if my medical providers understood or believed me. Now, I know they do. Thank you.
May I ask if your surgery was performed in front or back of your neck?
Physical therapy and acupuncture is helping me, omitting the prescribed pain pills whenever possible because they cause constipation, and taking Aleve or Tylenol.
I'm trying to prepare myself.
Good Luck.