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[Lorinda]

Good Morning,

Here is a brief synopsis of my issues:
I was in the front passenger seat of a car that was t-boned by a car running a red light at 50 mph on 12 Nov of this year.

Spent 3 days in hospital - mainly due to numbness & tingling which developed in both arms the first night. They did an MRI (after initial CT scan which was normal) of my neck - saw no swelling but gave me methylprednisonol for 24 hrs to be on safe side. I also had nausea problems - couldn't keep food down at all.
The docs said nausea would go away as would the numbness and tingling.
The right arm did get better after a week - left arm never got better.
Approximately 3 weeks later - started having severe nausea and vomiting like in hospital - then started having tingling again in right arm. Then on 6 Dec noticed weakness on left side - i am left handed and had trouble holding books in left arm and had trouble with clutch on truck - went to ER

They did CT scan (head), MRI (neck - found a mildly herniated disk C4-C5), MRA and all were normal with no signs of MS. THey did an SSEP which showed possible peripheral problems on right side and they did an EMG on left arm which was normal.
They checked thryoid function and ESR which were normal.
AT this point told me to see a psychiatrist - so I went - no conversion disorder etc.

My symptoms at this point are left sided weakness/tingling in arm and leg which get worse with activity. Strange head pains which start in the back of my head and move upward. Trouble swallowing on left side and numbness on left side on face. I also have been drooling at night (i wake up and the top of my shirt is soaked!)

On discharge I was diagnosed with complex regional pain syndrome which is strange because I never voiced complaints of pain only weakness and tingling. Appt at pain clinic is pending.

I am a very active person - cycle upwards of 100 miles per week.
I am not sure where to go from here - the docs say they cannot find an organic problem at this point but I am wondering if I am experiencing symptoms early or if something weird (outside the box) is going on? Where else should I look? Should I have anything repeated?

Thank you for your time,
Lorinda

[CCF Neuro[P] MD, RPS]

Dear Lorinda:

Sorry to hear about your accident.  The normal EMG that was normal, 3-4 weeks after the accident is good, as that would pick up nerve damage proximal from the brachial plexus.  The essentially normal MRI of the cerival spine also is good.  The mild herniation of C4/C5 is alittle difficult to pinpoint numbness where you describe.  This is usually around the shoulder and on the outside of the arm and maybe into the forearm.  Is the muscle weakness episodic are is constant these days?  

A post-traumatic migraine syndrome is not uncommon after an accident like yours.  The nausea might be due to this entity. What did the neurologist indicate?  Without seeing all the studies and examining you it is difficult to give you an idea what is really going on.  

I would do a couple of things.  The first is to see a good neurologist (second opinion) about the trauma and trauma induced migrine.  See if the numbness and weakness in the left arm improve over the next several weeks.  If nothing is better than I would recheck the EMG just to see if anything was missed.

Sincerely,

CCF Neuro MD

[Lorinda]

One last thing - forgot to add I am a 36 yoa female in excellent health prior to this (I am a helicopter pilot)

[Lorinda (again)]

Sorry - I also forgot to add (docs said this would get better too eventually). I have balance problems - and walk with a limp on my left side (foot drop) and also have noticed vision problems - shadowy type images in both eyes - not sure if this is related.

THank you again!

[Ross Oglesbee]

Question:  What is a DRS System?  My husband has significant lower back pain radiating into his buttocks on both sides and with tingling radiating down to his feet on occassion.  Thankfully, the pain can be relieved when he is in a prone position, but it is REALLY bothering and debilitating.  It has gone on for about 8 months and has not improved.  Our family physician recommended a neurosurgeon in NC who uses a DRS System that is described as a computer controlled mechanical system that decreases the pressure inside the disc resulting in reduction of herniation and relief of nerve pressure and back pain.  Is this something that you are familiar with?  Thanks.

[Lorinda (in response to muscle weakness)]

A quick note - the muscle weakness in my left leg and arm is always there - the more I do activity-wise the more weakness or fatigue and muscle soreness is there - this problem does not exist on my right side -
It is like the left side of my body is working harder than the right side when I am doing the same thing - (like cycling).

I am getting a repeat SSEP tomorrow (saw my primary neurologist today. He still is stuck on a psychological track because they can find nothing organic wrong with me.

I am pursueing a second opinion.

Thank you for your time,
lorinda

[CCF Neuro[P] MD, RPS]

Dear Lorinda:

I think that you need to resolve the perceived muscle weakness on your part and the neurological assessment of no muscle weakness.  I am not sure why this is happening?  The normal EMG would fit with the neurological assessment.  I would talk to your neurologist about this.  This might help clear up matters.

Sincerely,

CCF Neuro MD