Atlantoaxial Instability?

[Longcoolwoman]

I am a 44 yr old female and a mother of 3 in desperate need of answers.One morning I got up and within 45 minutes I had terrible pain that started at the base of my skull that went up over my head and into my forehead.If I tried to move or turn my head or walk it was almost unbearable.It felt as if it were coming from the atlas/axial area,that something was caught or not quite right.I ended up in the ER where I spent 9 hours and left in more pain than when I arrived.I have undergone countless MRIs with and w/o contrast, CT w/contrast/ many neck x-rays,endless bloodwork, spinal tap that lead to a leak which created a lot of problems for me as well as a very painful blood patch which failed to fix the leak.I was in bed for 7 weeks with terrible headaches, neck and shoulder cramping to the point I couldn't even sleep.Pain medications would not help the headaches that seemed to be coming from my neck and from different movements of my head.I lay on my back for 7 weeks with my laptop researching this nearly every moment trying to find answers as my Neuro and Neurosurgeon were a deadend.I am better but still have shocking sensations down both arms at times when I cough and at times just in the fingertips.I have cough/exertion type head pain here and there and still battle headaches related to head and neck movements.I never know from moment to moment how I will feel or what will happen next.I live on Valium and anti-inflamatories which only help a little. This all started 5 days after a neck adjustment. Any insight or guidance would be so appreciated as I need my life back!Thanks

[CCF-Neuro-M.D.-CS]

It sounds like you have been dealing with alot recently. Your case is very complex and it sounds like you have had a thorough evaluation. Have you had flexion and extension x-rays completed? This is a way to test the stability of your spine while doing normal movements. It is well known that cervical spine disease can cause headache, balance prblems, and neck pain. Also, even without significant cervical spine disease if the muscles of the neck are to tense these symtpoms may develop.

I would recommend that you be evaluated at an academic headache center. There you can have your films reviewed and a determination regarding further testing can be made. Also they can recommend a treatment strategy to help with your chronic pain. It may take a while, but if there is no underlying cause typically over time with meidcation help the pain will resolve. Good luck.

[Longcoolwoman]

Hi, Thanks so much for getting back to me.A chiropractor has just recently taken that type of x-ray and upon the intial viewing said there didn't seem to be anything really out of the ordinary but he would review them further and get back to me. I haven't heard from him so I will call him today to be totally sure.  Would instability cause the shocking sensations I mentioned?  Also lately I get the severe head pain that intially sent me to the ER.  I have found if I move my shoulders and turn and flex my head when the pain first begins, I can usually pull myself out of this, otherwise it is horrible.  The pain starts at the base of my skull and goes up over my head and at that point every movement exacerbates it, even breathing in deeply. The only thing that was really noted through all of the testing is that I have lost the orthodotic curve in my cervical spine, my C2 is rotated and I had an elevated SED-Rate test. I keep a dull headache which I deal with but when I do too much in a day, (just normal daily activities) I end up paying a price with terrible headaches. A good day for me is waking up without a headache and when it does come it only reaches a level 3 or 4. I also cannot bend over for any period of time without terrible neck and head pain.I have constant shoulder splinting as well. Any other thoughts on this would be so appreciated, especially on the shocking sensations I get when I cough as well as the cough/exertion headache.  Thanks so much....