Head Ache - Cervical Spne Disorder and Occipital Neuralgia

[shaider]

Dear Doctor,

First and foremost I would like to express my apolgy for almost writing the entire results of my MRI, I just want to give you a clear picture of my problem.I am experiencing severe pain at the left area of the  back of my head (skull area radiating to my eyes and forehead), pain and numbness of my neck and shoulder (left area also) for almost 4 yrs. I already consulted a neurologist and neuro surgeon for this problem. MRI of my Cervical Spine shows the following:

- Straightening of the cervical spine
- The intervetebral disks from C2-C3 down to C6-C7 exhibit decreased signal on the FSE T2-weighted study
- Mild posterior bulge is seen at C2-C3
- Combined spurs and central and left-sided posterior disk herniation is noted at C3-C4 with neural canal stenosis. There is also evidence of mild cord indentation. Some degree of degenerative neural canal narrowing is also appreciated on the right side
- Central posterior disk herniation is seen at C4-C5 without cord compromise. Uncinate hypertrophy is also observed espcially on the left side producing neural canal narrowing
- Posterior disk bulge and accompnaying spurs are also noted at C5-C6 and C6-C7. Degenerative neural canal narrowing is seen at C5-C6 on the left side secondary to uncinate hypertrophy

Impression:

Dessicated Disks, C2-C3 to C6-C7, Cervical Spondylosis at multiple levels C2-C3 down to C6-C7 with cord indentation at the level of C3-C4 and multilevel neural canal narrowing.

Based on the results of my MRI and complaints, my neuro surgeon said that I am suffering from occipitla neuralgia and the pain I am suffering at the back of my head is not related to my cervical spine problems. He referred to pain management center for greater occipital nerve blocking. I had already two sessions, but the pain I am experiencing is still persisting. My pain doctor is saying that the pain at the back of my head is also connected to my cervical spine problems. Currently aside from the nerve blocking, I am also taking Lyrica 75 mg (twice a day), Arcoxia 120 mg (once a day) and Myonal (3x a day).

Just to give you additional information, I had already two spine  surgeries last July 2003 (Laminectormy and Discectomy L5 and S1) and Transforaminal Interbody Fusion (L5S1), Screw Instrumentation Post lateral L4 L5 last Sept 2007.

My questions are:

- Aside from nerve blocking, what procedures aside from surgery I can have to treat my problems?
- Is the pain I am suffering at the back of my head (skull area) is related to my cervical spine disorder?
- Is it worthwhile to continue my nerve blocking?

I hope you can help me in  this problem.

Thanks

Shaider

[Dr Rajgopal]

Hi,
You may be suffering from Occipital neuralgia as your neurologist suggests but I must say that the numbness of neck and shoulder may be caused by cervical spine problems or at least aggravated by these. You need to correct the spine deformities as there is a spinal nerve compression due to the disc herniation and other problems. I would suggest you to take a second opinion on the condition and treatment plan. Another surgery may be required along with physiotherapy. Hope this helps you. Take care and regards!    

[snellcathy]

I have had similar problems. I was awoke from sleep at 5:30 in the morning with the right side of my head pounding worse than any migraine that I have ever had. I ended up vomiting all day long and then going to the E.R. where they gave me Zofran and Percoset 10 and sent me home. I was awake all night. The percoset did nothing for me and it doesn't take much to knock me out and the pain was still there. With it getting worse and the vomiting worse with numbness to my right ear, brow, eye and side of face we returned to the E.R. where they did a ct scan and said it was normal. They then gave me Zofran again which i proceeded to vomit through and Dilaudid which did nothing for me and sent me home with a referral to a Neurologist. The Neurologist was shocked that I wasn't being treated for my migraines by a Neurologist. He ordered an MRI and I waited 2 weeks until I finally had to call his office and asked for the results, I had already had his nurse tell me that Migraines weren't debilitating in the Dr.s eyes which was a shock. Then the nurse told me that my MRI results were normal. When I asked her where do we go from here, she stated, "Go back to your primary care doctor." I was referred to them to find out what was causing this..one MRI and they send me on my way. But they didn't know that I already had my MRI results and this is what they stated:

Disc signal is diminished suggesting desiccation. Defect in anterior subarachnoid space at C5-C6 is evident on sagittal series. Spinal cord intrinsically appears unremarkable.

C2-C3 Normal
C3-C4 Normal
C4-C5 Normal
C5-C6 minimal bulge
C6-C7 mild uncinate hypertrophy
C7-T1 Normal


Does this sound like a normal C-spine MRI to you. Please help I don't know what to do.

Cathy

***@****

[laurelye]

I too can relate to your problems, as I have been suffering 7 years now, after an accident whilst shopping, I hit my head on concrete, and have nerve damage, which has stopped me doing most things.  I try to cope but some days just have to lay in bed all day, I am not a miserable person but this takes some putting up with.  My pain comes from the back of my head which travels to my eyes as well, and at times get like a paralasis and cannot move at all, so I do sympathise with you.  Your post helped a lot.

Lauralye

[dancer333]

I so understand the agony you're going through.  My problems are so similar to yours except on the right side radiating into right jaw and right ear.  Have been to so many different doctors and don't think any really understand what I'm feeling.  Now with a neurologist and she's just giving me medications which had a bad side affect so not taking them.  Have had one occipital nerve injection which was so bad didn't want another one.  Also about 4 other injections in neck to no avail.  So tired of being in pain and dealing with this issue.  Hope we both get a solution.

dancer333