cervicogenic vertigo

Dear Doctor
I had disc replacement at C5/C6 and nerve decompression on the left side in December last year since then I have had problems.
I have felt unsteady which comes in waves.
I also have pain and numbness in my hands especially first thing in the morning. I have had an M.R.I. on the brain with no result and a scan to the neck to check blood supply which is also o.k.
I am having physiotherapy and was told I have a problem on the right side of the neck further up from my operation.
I am also being told that the vertigo is due to inner ear problems not the neck although my ears are fine and have been tested. There is no evidence for this.
Is it possible it could be cervicogenic vertigo.?
This is not recognised in the U.K.
Thank you so much

[Nassim Abi Chahine, MD]

Cervical MRI will exclude a CSF leak.
otherwise that also could be post traumatic PTSD after surgery

[pam1962]

Thank you for your comments. In Britain they put any sort of vertigo down to inner ear problems , so I am not getting much help in other directions. Can you tell me a little more about the post traumatic stress , how could this give me vertigo and what sort of treatment  may help. I am getting a lot of pain in my neck still and as soon as the physiotherapist started touching my neck I felt sick and dizzy.
Thankyou so much for giving me your time.

[Nassim Abi Chahine, MD]

Best surgeons are everywhere particularly in Britain, but maybe you asked the wrong specialty.. anyway please find out many information about PTSD on the web and pay attention on that in may be due sometime to a relatively low grade trauma exactly like a schedueled surgery, thats because it is "individual dependant", depending on the patient's threshold and resistance.
my advice to you is to take two types of medication now:
1- a muscle relaxant continuousely for a period of 3-4 weeks
2- an antidepressant acting on pain and subsequently reliefing muscle spasm like "Venlafaxine" (medication category SNRI).. fo a period of 3-4 months.

thank you again
D r Nassim

[silkcut]

I'm wondering however the MD could have reached a possible dx of Post Traumatic Stress Disorder based on the information given.

Equally PTSD doesn't present with just a sense of  vertigo. The three diagnostic criteria for PTSD are:
http://www.rcpsych.ac.uk/mentalhealthinfo/problems/posttraumaticstressdisorder/posttraumaticstressdisorder.aspx

1. Flashbacks & Nightmares

You find yourself re-living the event, again and again. This can happen both as a "flashback" in the day, and as nightmares when you are asleep. These can be so realistic that it feels as though you are living through the experience all over again. You see it in your mind, but may also feel the emotions and physical sensations of what happened - fear, sweating, smells, sounds, pain.

Ordinary things can trigger off flashbacks. For instance, if you had a car crash in the rain, a rainy day might start a flashback.

2. Avoidance & Numbing

It can be just too upsetting to re-live your experience over and over again. So you distract yourself. You keep your mind busy by losing yourself in a hobby, working very hard, or spending your time absorbed in crossword or jigsaw puzzles. You avoid places and people that remind you of the trauma, and try not to talk about it.

You may deal with the pain of your feelings by trying to feel nothing at all - by becoming emotionally numb. You communicate less with other people, who then find it hard to live or work with you.

3. Being "On Guard"

You find that you stay alert all the time, as if you are looking out for danger. You can't relax. This is called "hypervigilance". You feel anxious and find it hard to sleep. Other people will notice that you are jumpy and irritable.

[pam1962]

Thank you for your comments, doctors are now looking at other possibilities for my condition including fibromyalgia and cervical vertigo.
I do agree with your comments.
Pamela