Dystonic posture/ Chronic pain

[KremmBrulee]

Please advise if the cervical spondylosis that was found on the MRI used to rule out MS is related to the dystonic posture for 5+ years. C 5-6 and c-6-7 are affected. Weakness in shoulders neck, pain, decreased ROM. at first thought it was the oromandibular dystonia itself however the correct meds/ botox injections have been found to control the movements. PT has not helped with the weakness. I wear a TENS unit, am unable to exercise in the manner I used to, 3 lb weights are too much towards the end of a work out. Standard push ups are not possible any mroe. Cannot turn head and place chin on shoulder any longer. Constant burn at point where neck nuscle interlaces with shoulderblade. tension headaches are 5 days/ week at base of skull- occibital bone.

[KremmBrulee]

My movement specialist has ruled out MS, Wilsons and Huntintons Disease. My MRI came out clear as day, there was no inclination of MS on the MRI of brain or brain stem, he did thin slicing to ensure that we did not miss this.

[Dr Sharma]

Hi there. I would not like to attribute all these symptoms to the cervical spondylosis. These neurological symptoms and progression over 5 years could be could be due to a chronic demyelinating condition called multiple sclerosis where the disease phase is characterized by active phase and remissions. It has multiple symptoms and signs and is a diagnosis of exclusion. The symptoms of multiple sclerosis are loss of balance, muscle spasms, numbness in any area, problems with walking and coordination, tremors in one or more arms and legs. Bowel and bladder symptoms include frequency of micturition, urine leakage, eye symptoms like double vision uncontrollable rapid eye movements, facial pain, painful muscle spasms, tingling, burning in arms or legs, depression, dizziness, hearing loss, fatigue etc. The treatment is essentially limited to symptomatic therapy so the course of action would not change much whether MS has been diagnosed or not. Apart from clinical neurological examination, MRI shows MS as paler areas of demyelination, two different episodes of demyelination separated by one month in at least two different brain locations. Spinal tap is done and CSF electrophoresis reveals oligoclonal bands suggestive of immune activity, which is suggestive but not diagnostic of MS. Demyelinating neurons, transmit nerve signals slower than non-demyelinated ones and can be detected with EP tests. These are visual evoked potentials, brain stem auditory evoked response, and somatosensory evoked potential. Slower nerve responses in any one of these is not confirmatory of MS but can be used to complement diagnosis along with a neurological examination, medical history and an MRI in addition, a spinal tap. Therefore, it would be prudent to consult your neurologist with these concerns. Take care.