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Neurotic Anxiety /cervical problem?
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Neurotic Anxiety /cervical problem?


  I have posted my 22 year old son's weird physical symptom to the forums.
  The feedback from your doctors was more on mental disorder than neurological one.
  Recently I have my son on last physical check up on his cervical spine.  
  It was suggested by a chinese doctor.  She said something wrong with his
  cervical spine.  He must have injured when he was young.  The bone is degenerated.
  After several session of manipulated his spine, my son felt the sensation of pressure
  more actively crawling around his neck and cheek.  We had his MRI done.
  I am citing the MRI reading as follow:
  There is normal alignment at both the cervical and thoracic spines.  Vertebral body heights
  well preserved.  Mild disk space narrowing and disk desiccation are seen
  predominantly in the mid to lower cervcal spine.  Marrow signal is normal and homogeneous
  thoughout.
  The spinal cord is of normal caliber and signal intensity throughout
  its length.  Craniocervical junction is unremarkable.
  C2-3 and C3-4:  No significant disk protrusions or extrusions, neural foraminal or central canal
  compromise.
  c4-5:  Small central disk protrusion without significant neural foramina nor central canal compromise.
  c5-6:  Moderate sized right paracentral disk protrusion which causes mild
  effacement of the ventral thecal sac and cord creating mild central stenosis and moderate
  right neural foraminal narrowing.
  c6-7:  Large left lateral disk herniation extending into the left neural
  foramen and causing severe neural foraminal narrowing.  Mild right-sided uncovertebral
  osteophytes are present creating mild right neural foraminal narrowing.
  No significat central stenosis is seen.
  c7-T1: No significant enural foraminal nor central canal comprosise.
  IMPRESSION
  Degenerative disease of the mid to lower cervical spine.  This is
  most severe at the c5-6 and c6-7 levels.  At c5-6, there is a right
  paracentral disk protrusion which causes moderate right neural foraminal narrowing
  and mild central canal stenosis.  At c6-7, there is a large left lateral disk herniation
  which causes severe left neural foraminal narrowing.
  
  Recently my son felt pressure on his left hand.  I am wondering does this
  crawling sensation of pressure is caused by cervical spine problem?  Or
  it is just psychosomatic symptom?  For six years, we have been tossed between
  mental and physical category.  We need your advice how to approch this difficulty
  illness.
  IM

  The spinal cord is of normal caliber and signal intensity throughout its length.  
===========================================================================
Dear Helen:
The left C6-7 disc can potentially cause left arm, shoulderblade, and forearm pain, hand numbness, and mild arm and forearm weakness. The cervical spine abnormalities, however, can not explain the numerous head symptoms that I recall your son suffers from. I continue to suspect that there is a significant psychogenic contribution to your son's symptoms.
I believe that chiropractic or similar manipulation of the cervical spine may not be the safest treatment of your son's problem. I would again advice you to encourage him to persevere with a psychiatrist, and also seek a neurological opinion from a competent clinical neurologist to determine the relevance of the cervical spine MRI abnormality.
Good luck!




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