4 months post-op decompression...permanent nerve damage?

Hello,

I am a 25 year old female finally diagnosed with Chiari I malformation of about 6 mm in October of 2008 after feeling pretty much crazy for 3 years.  I live 2 hours south of Chicago, and was able to have my surgery performed in December of '08, which was pretty quick.  Being a doctoral student in physical therapy, I had only about 6 weeks to "recover" before heading back to clinical rotations.  I was able to do so with no major restrictions from my neurosurgeon at RUSH.  My previous neuro symptoms such as nystagmus, dizziness, pressure behind my R eye, intolerance to light, and horrible occipital headaches and jaw pain have stopped, but my early symptoms of constant R sided pain burning pain and weakness have not really let up.  To be honest, it feels pretty bad, especially if my neck is in flexion documenting at work.  This is a different pain than the post op spasming of the cervical musculature. I feel quite a bit of burning and muscle spasm, but ONLY on my R side. I also had no evidence of syrinx in my C-spine, but my neurosurgeon never MRI'd my entire spine, as he felt no need to. Never has the Chiari affected the L side of my body, but the surgeon did say when he opened me up I had adhesions around the base of my cerebellum, which he removed.  Now, I must say that my surgery included decompression and duraplasty with bovine pericardium graft, but it did NOT include C1 laminectomy, as my surgeon did not feel it necessary since the herniation was not to C1. Could that be the problem?  I really am active and wanted to avoid any instability the laminectomy may cause in the future. I realize that the R sided spasm is also irritating my brachial plexus in the area of the scalenes, and I feel that even with mild physical therapy (soft tissue mobilization), posturing, and strengthening, it is just not getting any better.  Is it possible that I have R sided permanent nerve damage, and that my musculature will just never relax? I usually think of more of a flaccidity effect with something like this, but it's not like I am spastic, just horribly spasmed. I feel blessed to be walking and doing things, but boy does this hurt.  I try so hard to stay away from pain meds, but when it gets bad (if I don't get at least 8 hours of sleep and have a busy day), boy does it hurt bad.  Also, in the past year I have developed pretty severe Raynaud's in all 10 of my toes...is there any research to suggest this is related to the Chiari, or would it be more likely related to my Yasmin birth control?  Please note that my symptoms started 3 years ago in PT school when we were practicing a technique that includes end range cervical extension. Before that, I had had a few concussions in my day from playing basketball and riding dirtbikes, had post concussion syndrome, but never ever had anything like this.

Thank you for any help or insight you may be able to offer,

nina2BDPT

[selmaS]

Hi Nina,

I also have chiari and raynauds and there is a link to those with chiari and autoimmune disorders of which raynauds is one.

Since chiari is congenital, it is possible that the head traumas and cervical extensions triggered the symptoms.

Since u had the decompression with a dura patch....I am wondering if u have a syrinx or a tethered cord. There is no cure for chiari only treatments to reduce the symptoms.

Also the instability u r speaking of could be anothe r related condition..cervical cranial instability.

I do not know who u had do ur surgery, but it is important that u see a chiari specialist for the instability issues.

I wish to invite u to join our chiari forum here on MedHelp...to share ur experiences and info...

I hope to see u in the chiari forum
"selma"