Cervical Herniation, Later Followed by Laundry-List of Undiagnosed Neurological Symptoms

[monarog]

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.

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

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.

[patsy10]

I'm 44 yo female and have almost to a tee, exactly what you describe...Spontaneous disk herniation 2002, which resolved.  In 2005 sudden leg weakness, hyperreflexia, followed by spinal fusion.  I got much worse a few days after surgery and have never recovered.  I have almost exactly the same symptoms you listed.  My MRI report sounds much like yours except it was level c-5/6.I've had all the tests too.. all normal.  You may never know what it is.  My most recent MRI showed Chiari 1 malformation.  The neuro said he doesn't think the Chiari is causing the problem but said it still could be a c spine issue.  He said there is no known test in modern medicine that could diagnose my condition but he doesn't feel it is something really bad as most of my symptoms are sensory and I haven't progressed over the past 2 years since it started.  I know what you are going through.

[monarog]

Hi patsy10...

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.

[patsy10]

I've been living your worst fear for almost 2 years.  My "new life" is not a lot of fun.  Every day, hour is a surprise.  There is just no way anyone could ever accept this or get used to it.  I myself have seen 4 neuro's, a rheumy, fibromyalgia specialist.  No one has given me a clear answer that is substantiated by objective, medical proof because all my tests are normal.  The only thing they have all been consistent with is that is isn't MS.  I have been given the fibromyalgia diagnosis by several of them.  The one I saw recently was the one who told me there is no test for whatever I have.  I guess I just have to live with it and hope it goes away.  I will say I had a similar syndrome to this back in 1993.  It resolved within about five years and I was close to normal for about 7 years or so.  I surely hope whatever you have resolves in time.  It's no fun at all...

[patsy10]

I forgot.  I did try Neurontin after surgery when I was the worst.  It didn't do anything.  It does help some people.  The neuro said we could try meds. like Lyrica, Neurontin, Cymbalta for the symptoms.  He said the meds may tone it down some but won't take it away.  I'm not into taking medications so I'm just going to continue as I am.  I would take them if would resolve the symptoms though.

[hurtinginca]

Patsy10 you said, “Still have symptoms, changing literally hourly.”  

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.

[patsy10]

It was done through the front.  It was only one level.  I think they use the posterior approach for multi-level fusions.  

Good Luck.

[suellis]

I've suffered with identical symptoms as all of you. I did complete the Cervical Spine fusion C5:C6 in 11/03. Seemed to instantly alleviate arm, shoulder and neck pain but after returning to work and using my arms routinely ALL pain returned. Completed 7+ months of PT to increase ROM (range of motion) and strength. PT increased pain and recreated severe neck pain at base of skull (pain to the point of vomiting). Keep in mind I had MRI's, Discography, and many injections prior to my fusion. I rec'd sympathetic nerve blocks, occipital nerve blocks, blocks at C3 to C8, Gangleion blocks, etc. My fusion was completed 11/03 by a wonderful Neuro who successfully fused my L5:S1 in 2001 and carpal tunnel release of a Persistent Median Artery in addition to the Median Nerve in early 2003. The fusion left no scar on the front of my neck. I have cadaver bone and a titanium plate about the size of a postage stamp with rods to keep in place. All healed well but I now have a perm. 5 lb lifting restiction since I'm only 110 lbs and have two spinal fusions. Overuse of my arms, neck, upperbody or positioning for to long (traveling via flight, road trip, etc) all seem to inflame my nerves. I still receive quarterly injections for the neck. We've discussed disabling the sympathetic nerves via cardiovascular surgery. Bottom line I feel most of this was caused by a case a Viral Meningitis in fall of 1999. I just recently found out that my Meningitis from 1999 & 2003 was really West Nile Virus that the same hospital ER failed to diagnose twice! I urge all of you to seek testing for exposure to WNV and then seek out a Cerebal Spinal Fluid Specialist for subsequent evaluation/testing pending confirmation. WNV causes a myriad of Central Nervous System damage depending on the severity (brain swelling incurred). My neuro ordered another cervical MRI last year which showed bulging now at C3:C4 and herniation at C7:C8. I have permanent L. Arm/Shoulder nerve pain, vertigo, rapid heart rate (tachycardia), REM (rapid eye movement), continuous grinding and popping of cervical spine, shoulders and arms. All of this and only 33. Waiting for new technology and possibility of another cervical fusion for assistance. I wish you all luck and let me know if you'd like to see a wonderful, compassionate, highly skilled Neuro-Surgeon in Indiana!

[dlinsell]

A related discussion, Cervical Herniation with Nausea was started.