1. There is electrodiagnostic evidence of a bilateral ulnar, motor, axonal mononeuropathy in the bilateral upper extremities. However as noted above, these low amplitude ulnar motor responses are most likely dure to patient’s intolerance of higher current strengths vs. a bilateral ulnar, motor, neuropathy in the upper extremities.
2. No electrodiagnostic evidence of a neuropathic or myopathic process in the bilateral upper extremities on the needle study.
3. Along with the nerve study, there is no evidence of any other neuropathy or a plexopathy or a radiculopathy in the bilateral upper extremities on this study.
4. Clinical correlation is recommended. Recommend a repeat nerve study only in 3 months.
Final report MRI of cervical spine: 1- disc desiccation at C2-C3 down to C6-C7.. 2- straightening of the normal cervical lordosis. 3- Extradural right paracentral T1W isointense/T2W ISO-to hyper intense focus 5.0 mm at c6-c7 which abuts the anterior aspect of the spinal cord and causes stenosis of the right neural foramen with the extradural focus contacting the visualized right c7 exiting nerve root. Consideration is an acute epidural hematoma.
This is your problem, plain and simple.
You have a pinched nerve.
The nerve is being compressed.
You have cervical vertabrae numbered C1-C-5.
In between each segment of bone is a pad, or disc, composed of cartilidge.
One of the pads is squished, swollen and inflammed.
A nerve runs through the spinal column and out under the verterbae and across the pad.
Because of the swelling pressure is on the nerve, which causes pain. The pain is usually lower, under the shoulder or down the arm.
The drill is to:
(1) Reduce the inflammation. This is usually done by use of oral prednisone.
(2) Reduce pressure on the nerve.
(a) this is accomplished by means of intermittant axial traction, pulling the head upwards along the axis of the spine.
(3) A soft cervical collar or stiff neck brace is contraindicated. It will cause atrophy of the supportive musculature. I
(4) Avoid up-and-down motions such as riding in a truck. Get an infklatable cushion to put under your butt.
(5) In weeks, begin range of motion exercises through the limits of pain, rotating your head through 360 degrees.
(6) Stay well-hydrated
(7) Avoid over-eating. Keep glucose levels low. High blood sugars affect osmolality and increase pain.
(8) Painkillers such as oxycontin and contraindicated.
(9) Under no circumstances use a muscle relaxant. It will cause the head to settle against the nerves and cause more pain.
(10) Under no circumstances use a neck brace. It will cause degradation of the musculature that supports the head.
(10) After a few weeks do sit-ups, which strengthen the muscles which support the head.
Hi, Thank you for your question. Your reports suggest that your symptoms may be due to nerve irritation in the cervical (neck) spine because of cervical disc bulge. This pain may be referred and perceived as occurring in the back of head & shoulders (as electric sensation)- LHERMITTES SIGN, arms or chest, rather than just the neck. Other symptoms may include vertigo, nausea (dizziness) and stiffness. It will be best that you consult a neurologist who would like to prescribe Pain killers, steroid and muscle relaxants. Other treatments could be cervical orthosis such as a soft cervical collar or stiffer neck brace to restrict neck movement till you get complete recovery. In addition, cervical traction may also be suggested by the doctor, if condition is severe. Hope this helps.
Loss of lordosis is referring to the natural curve that we have in our neck, you have lost some of that, many people do. However, your vertebral alignment is fine.
Disc desiccation at C2-3 to C4-5 intervertebral disc noted
Disc desiccation simply means that the disc has a reduction in water content, it’s just part of the aging process, but can be helped along by trauma or repeated injuries. It’s really nothing to worry about. You have it in 3 discs at C3, 4 and 5.
Diffuse disc bulges are seen at C3-4 and C4-5 indenting the thecal sac without any cord or neural compression
There is a disc in between each of the vertebra in our spines. As we get older our discs degenerate and sometimes bulge, which means that they extend past the area they would normally occupy. This finding is very common in people as they age and often causes no symptoms what so ever. It’s not a herniated disc, that’s a more serious problem. You have one at C3-4 and another at C4-5 indenting the thecal sac. The thecal sac encases the spinal cord and contains fluid to protect and feed the nerves. Indenting in this context means pushing or compressing. So the report is saying that your disc bulge is indenting the thecal sac but is not compressing your spinal cord or nerves.
Cranio-vertebral junction is unremarkable; this means that everything is okay at this junction.
There’s nothing in this report that’s particularly concerning or worrisome. The best treatment for your pain at this point would most likely be Physiotherapy. Treatments such as mild stretching, heat, massage, ultrasound, strengthening and postural exercises. These things can be very effective in reducing pain.
Take Care