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1207048 tn?1282174304

Is this something I should ask them to check at my MRI?

I have a return of the very tight shoulder and neck muscle on my right side. It is very uncomfortable when I turn my head at all. The muscle is very tight feeling if you touch it. I've had this for 3 days now.

I also have a return of the eye pain/ headache in my left eye. It feels like a sharp pain behind my eye that radiates towards my ear and sometimes the jaw. If I push against my jaw, right in front of my ear, the sharp pain will ease up a bit. The eye pain/ headache is constant but will have occasional sharp shooting pains that radiate towards the ear. This also started at the end of last week, and has been getting progressively more uncomfortable every day.

I go on Friday afternoon for an MRI of my head, neck, & full spine (with & without contrast). Would a possible cause for both these issues show up on an MRI? If so, is this something extra that my neuro should ask them to check for?

I will see my neuro to go over the MRI results next wednesday (the 17th). I've decided it is time to talk to him about using gabapentin during the day also (right now I just take 300-500 mg at night before bed).

Thanks for any help you guys have! I'm not sure what this eye pain/ face pain could be...or why it keeps coming back :-(
~Jess
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1207048 tn?1282174304
Just a quick update: I called my neuros office, and he said he already requested a "special look" at my optic nerve and brainstem. He thinks I have had ON but without too many symptoms, and he thinks that the vertigo is caused by the brainstem or cerebellum.

He said we will talk more about the muscle issues next week when I see him for the results.
Thanks guys!
~Jess
Helpful - 0
667078 tn?1316000935
They read the whole study and report on it such as Sinuses and Spinal stenosis. As a patient they do not listen to requests to look for something. The Doctor has to ask for specific things.

Alex
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1207048 tn?1282174304
Thanks Bob & Alex! I'll give my neuro a call and see what he does with the info :-)
~Jess
Helpful - 0
1453990 tn?1329231426
That is pretty strange.  The current standards and practice requires radiologists to read the whole study.  They can expand on the diagnostic area stated, but it is unethical and may be malpractice not to read the complete study.  Just because someone has a broken collar bone, does not mean that the radiologist can ignore the tumor or pneumonia that is on the film.  This is the reason that almost every MRI of the Brain and Neck to R/O Demyelinating Disease comments on disk issues and mucus retention cysts in the sinuses.  Send me a private message about what RTP hospital you are being imaged at.  I'd like to know if I know any of the Docs there.

Bob
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667078 tn?1316000935
The hospital where I have my MRI only looks at what the Doctor orders period so you may need to mention it to the Doctor before the MRI.

Alex
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1453990 tn?1329231426
Oh, and on the tight muscles in the shoulder and neck.  There isn't much for MRI to see in muscle per se.  They may see a disk condition in the neck that is leading to a radiculopathy of the right shoulder and neck.  If there is no neck pathology, this could be a spastic muscle condition.  Several people on the forum have discusses spasticity of the shoulders and between the shoulders.

Bob
Helpful - 0
1453990 tn?1329231426
Hey Jess,
The pain "behind the eye" sounds a lot like the pain I had with Optic Neuritis.  I don't remember if you have had that before.  The part that is a little strange is the pressing in front of the ear.  That is where the trigeminal nerve passes.  The first branch of the trigeminal nerve provides feeling to the globe of the eye.   If it is Optic Neuritis, the Optic Nerves, Optic Chasm, and Optic Tracts can be visualized on MRI.  My optic Neuritis showed up as a narrowing of the channels (see my journal).  If you need a refresher on how the optic nerves, optic chasm and optic tracts relate to the eyes and optic cortex of the brain, see:

http://www.medhelp.org/posts/Multiple-Sclerosis/Picture-of-how-Optic-Nerves-and-Optic-Tracts-work/show/1387788

If it is trigeminal neuralgia (TN), it depends.  The facial part of the trigeminal nerve is pretty hard to visualize on MRI.  The insertion of the Left and Right trigeminal nerves is at the brainstem, so a lesion on the brainstem could be a cause of TN.  The problem with TN, is that there are place it can demyelinate as it passes from the brainstem to the front of the face and as it splits into the three branches on each side of the face.

Bob
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