Epilepsy or C-spine problems

[jan]

I am f., 49 yrs. old, 5'5" and 135 lbs., don't drink or smoke.



Over the period of a couple of days I had an incident while reach'g with L.arm, it was difficult to reach fwd and jerky. Another day suddenly couldn't put wt. on L. leg, it felt wobbly,jerky. Next day L. foot jerk'g while using sew'g machine, later that day my whole L. side suddenly felt weak & strained, my L.side of head tingly.  These did not last more than a minute, but some feel'g may have lingered.



Normal CT and blood work at ER (day of L. side weaknesss) and MRI in April showed no changes (that was done for another reason, can't remember it, though).



My neuro thinks seizure, but I am wonder'g if it couldn't be from my neck (c-4-c7 herniated discs, spurs, stenosis, radiculopathy R. side)  I did have a diag. of partial seizures (complex and simple) in the past and was on meds 3 yrs., been off 2.  She said "rule out seiz", so I asked if she thought it was and she said "What else could it be?".



There are times I want to move L. finger once and it goes 2x's, or W/o warn'g just jerks 1x, L. leg jerks @ times, just once.  My R. leg gets tight in back and at times I can't put my wt. on it for a few secs. My r. sided problems also stem from 3 lesions in corpus callosum, but MS ruled out. No new lesions in 8 yrs.



I have a bunch of chronic diag, but never get normal illnesses.



My question is could it be from my neck?  My leg didn't feel like a rhythmic jerking, although it could've been.



Thank you for any insight you can give.

[CCF-Neuro-M.D.-SH]

First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes.  

   The symotoms you describe are complex and there is a lot of information that I do not have.  I sounds like what you are describing is a transient period of Left sided dysfunction (with jerky incoordination) and then weakness that completely resolved (you mentioned the "day of the weakness", I assume it resolved).  

  This history is unlikely to be a result of a C-spine radicular lesion.  A radiculopathy (nerve root lesion caused by compression/disc disease) in the cervical spine generally starts with pain in the neck and then shooting pains down the arm.  If the lesion is bad enough to cause weakness and leg symptoms it would be unlikely to resolve quickly (althougth there can be variable presentations).  An EMG would be able to decipher whether you are having significant compression in your C-spine region.

   The symptoms you describe are more consistent with your known seizure disorder.  Complex partial seizures can cause episodic dysfunction, jerks and transient weakness on one side of the body (called a Todd's paralysis).  If your dysfunction is due to epilepsy, I suspect you had a series of seizures over the couple of days you had symptoms.  I would recommend that you get an EEG (electroencephalogram or "brain wave test") to see if you are having increased epileptic activity.  You should also consider restarting your anti-seizure medications until the nature of your spell is known.  You could have a fatal car accident, drown in a bathtub etc. if you are having uncontrolled seizures. The intermittent jerks of the Left leg that you describe are consistent with myoclonus and can be part of your epileptic syndrome.

  That being said, it does not mean that you do not have cervical spine disease.  I sounds that you have several lesions in your corpus callosum and lesions that affect this area (usually demyelinating) can also cause demyelination in the spine.  For this I would recommend an MRI of the cervical spine with and without contrast.  If suspicious lesions are found then a lumbar puncture would be needed to examine your spinal fluid for inflammation. I hope this has been helpful.

[jan]

It has been helpful.  Thank you.