Aa
L5,S1 and Fasciculations
Thank you in advance for any help you may provide.
My husband (37 y/o) had neurosurgery two years ago for a badly herniated L5 S1 disc. This provided relief from terrible muscle spasms in his back and left leg and foot, weakness in left leg and foot and reduced sensation. Six months ago he started to have fasciculations in his left calf. Over time the fasciculations spread to his entire leg and increased in severity and frequency to the point of creating fatigue in his leg. He revisited the neuro group. They put him on Tegretol which helped a little but not really significantly. Neurontin was tried next which helped even less. The neurologist had an MRI done just to check. Sure enough the same disc was badly herniated on the same side. He was also found to have a narrow spinal column (congenital). The compression on the sciatic nerve definitely warranted surgery.
Surgery was completed two weeks ago. A gel was painted on his nerve to help with build up of nerve tissue. The fasciculations have lessened a little in both severity and frequency. His leg is still weak which doesn't surprise me and his back is too, but that seems part of the healing process from surgery.
My questions are:
1. Is it probable that the fascicultions will continue to diminish over time?
2. Will the nerve continue to heal and if so how long is typical in the healing process?
3. I understand the gel has recently been approved by the FDA. What is the buzz on the effectiveness of this gel?
4. How likely is a disc to herniate a third time? More likely or no more likely than an individual who has never had a herniated disc?
Thank you!
My husband (37 y/o) had neurosurgery two years ago for a badly herniated L5 S1 disc. This provided relief from terrible muscle spasms in his back and left leg and foot, weakness in left leg and foot and reduced sensation. Six months ago he started to have fasciculations in his left calf. Over time the fasciculations spread to his entire leg and increased in severity and frequency to the point of creating fatigue in his leg. He revisited the neuro group. They put him on Tegretol which helped a little but not really significantly. Neurontin was tried next which helped even less. The neurologist had an MRI done just to check. Sure enough the same disc was badly herniated on the same side. He was also found to have a narrow spinal column (congenital). The compression on the sciatic nerve definitely warranted surgery.
Surgery was completed two weeks ago. A gel was painted on his nerve to help with build up of nerve tissue. The fasciculations have lessened a little in both severity and frequency. His leg is still weak which doesn't surprise me and his back is too, but that seems part of the healing process from surgery.
My questions are:
1. Is it probable that the fascicultions will continue to diminish over time?
2. Will the nerve continue to heal and if so how long is typical in the healing process?
3. I understand the gel has recently been approved by the FDA. What is the buzz on the effectiveness of this gel?
4. How likely is a disc to herniate a third time? More likely or no more likely than an individual who has never had a herniated disc?
Thank you!
Dear Diana:
What did your neurosurgeon say? I am not trying to be "smart" but these type of surgeries are so individual, each patient returns to optimal function at different times. If the source of the nerve damage is corrected, fasciculations should improve. As those nerves who are destined to die, die off, the fasiculations will cease in those dead muscle fascicules. Those nerves who remain irritiated, those muscle groups will continue to have fasciculations. Yes, the nerves from the spinal cord are peripheral and they can regenerate. There are too many factors that are unknown to me, thus I can not say, but the general rule is that 18 -24 months is the outside time frame for regeneration. The data is not entirely clear about large numbers of patients. From what I hear, the data is encouraging but I would not bet the family fortune on it being the cure all for nerve damage. In fact, I have reservations about the effectiveness long term. But, I think it will help. Whether a disc will herniated again is a compound question/answer depending on the etiology. If it is osteo then likely it will not get much better over the long term. But, it also depends on how your husband changes his lifestyle and habits.
Sincerely
CCF Neuro MD
What did your neurosurgeon say? I am not trying to be "smart" but these type of surgeries are so individual, each patient returns to optimal function at different times. If the source of the nerve damage is corrected, fasciculations should improve. As those nerves who are destined to die, die off, the fasiculations will cease in those dead muscle fascicules. Those nerves who remain irritiated, those muscle groups will continue to have fasciculations. Yes, the nerves from the spinal cord are peripheral and they can regenerate. There are too many factors that are unknown to me, thus I can not say, but the general rule is that 18 -24 months is the outside time frame for regeneration. The data is not entirely clear about large numbers of patients. From what I hear, the data is encouraging but I would not bet the family fortune on it being the cure all for nerve damage. In fact, I have reservations about the effectiveness long term. But, I think it will help. Whether a disc will herniated again is a compound question/answer depending on the etiology. If it is osteo then likely it will not get much better over the long term. But, it also depends on how your husband changes his lifestyle and habits.
Sincerely
CCF Neuro MD
Dear Dr.I thank you in advance for you're expertise...
I had a severly herniated disc at the L4-L5 with compression to the Cauda Equina...surgery was done in June 98...microsdiscetomy,, laminectomy and spinal decompression...following 5 months of compression.
These "fasculations" that people discuss...is that what is happening in my leg when my leg "spasms and jerks"? Both my legs do this, the right worst than the left. I remain with no ankle reflex on right along with diminshed knee on both right and left leg, and diminished reflex on the left ankle as well.
I am not concerned with it, I assume it is from nerve damage to the right leg...I have severe back pain when standing especially, also severe when sitting on a hard surface...walking is not too bad, although limited...when you say nerves regenerate at 18-24 months...is there a chance I could still have some recovery even tho it is 16 months ago from surgery?
I had a new MRI that shows scar tissue compressing the L5 nerve root, and also scar tissue in the area of the L5 where the disc was removed...do you think I would improve if I had the scar tissue removed with additional surgery? My Neurosurgeon made no suggestions other than that I will have to take muscle relaxants, pain meds, and arthitis med for the remainder of my life...I am 43 F...any suggestions?
I had a severly herniated disc at the L4-L5 with compression to the Cauda Equina...surgery was done in June 98...microsdiscetomy,, laminectomy and spinal decompression...following 5 months of compression.
These "fasculations" that people discuss...is that what is happening in my leg when my leg "spasms and jerks"? Both my legs do this, the right worst than the left. I remain with no ankle reflex on right along with diminshed knee on both right and left leg, and diminished reflex on the left ankle as well.
I am not concerned with it, I assume it is from nerve damage to the right leg...I have severe back pain when standing especially, also severe when sitting on a hard surface...walking is not too bad, although limited...when you say nerves regenerate at 18-24 months...is there a chance I could still have some recovery even tho it is 16 months ago from surgery?
I had a new MRI that shows scar tissue compressing the L5 nerve root, and also scar tissue in the area of the L5 where the disc was removed...do you think I would improve if I had the scar tissue removed with additional surgery? My Neurosurgeon made no suggestions other than that I will have to take muscle relaxants, pain meds, and arthitis med for the remainder of my life...I am 43 F...any suggestions?
Dear Deborah:
You really need to talk to your neurosurgeon as I previous stated. Most likely the scar tissue would just recur. Surgery is usually the last resort and outcome is always guarded. The recover depends on rehab and the performance of the surgeon. Since your lesion is surgical but the etiology? so I can not say too much about regeneration but at this point I think you have what your going to have. Sorry, but there are no good answers after surgery. Stick to your rehab, do not overload your back, use proper form in all activities, and make sure you keep your self fit and in condition.
Sincerely,
CCF Neuro MD
You really need to talk to your neurosurgeon as I previous stated. Most likely the scar tissue would just recur. Surgery is usually the last resort and outcome is always guarded. The recover depends on rehab and the performance of the surgeon. Since your lesion is surgical but the etiology? so I can not say too much about regeneration but at this point I think you have what your going to have. Sorry, but there are no good answers after surgery. Stick to your rehab, do not overload your back, use proper form in all activities, and make sure you keep your self fit and in condition.
Sincerely,
CCF Neuro MD
Thank you Dr. MD....I was just hoping you may say something different than my Neurao...he is an excellent NS and I trust him and his judgement...thanks again!
your welcome.
CCF Neuro MD
CCF Neuro MD
What do you mean by the etiology? You made reference to it in my earlier post...regarding the possiblity of nerve regeneration and the fact that I have scar tissue compressing the L5 nerve root and it is also in the L5 disc area where the disc was removed...thanks
Dear Deborah:
Etiology means the reason for the scar tissue, and the disc problem. If the etiology was due to arthritis then the outcome would be different than let's say congenital abnormality, or obesity, or furniture lifter.
CCF Neuro MD
Etiology means the reason for the scar tissue, and the disc problem. If the etiology was due to arthritis then the outcome would be different than let's say congenital abnormality, or obesity, or furniture lifter.
CCF Neuro MD
I hope I can answer the etiology ??? I slipped on ice in the parking lot resulting in a large central to paracentral right disc herniation in the L4-L5 in Jan 98....in June 98 I underwent spinal decompression, laminectomy and microdisectomy....the myelogram showed severe compression to the L5 nerve root...which was causing right foot drop and a complete right leg and foot feeling of "deadness" along with back pain...the MRI done in 98 did show Arthitis, DDD, and spinal stenosis...none of which caused any problem prior to the herniation...
Following surgery my Neurosurgeon this past June 99, after a new MRI was done...which showed the epidural fibrosis...scar tissue compressing the L5 and within the area where the disc was...I was told that I would be on pain meds, arthitis meds & muscle relaxants for life ...that I have residual Cauda Equina Syndrome and Chronic Radiculopathy....I am 43 F....so even tho it is 16 months later..do you think L5 nerves could regenerate?? maybe...? ;-) thank you
Following surgery my Neurosurgeon this past June 99, after a new MRI was done...which showed the epidural fibrosis...scar tissue compressing the L5 and within the area where the disc was...I was told that I would be on pain meds, arthitis meds & muscle relaxants for life ...that I have residual Cauda Equina Syndrome and Chronic Radiculopathy....I am 43 F....so even tho it is 16 months later..do you think L5 nerves could regenerate?? maybe...? ;-) thank you
Dear Deborah:
I think that it has been too long. Your injury occurred in Jan of 1998 if I read your posting correctly. The passage of time has been too long.
Sorry, I don't have better news.
Sincerely,
CCF Neuro MD
I think that it has been too long. Your injury occurred in Jan of 1998 if I read your posting correctly. The passage of time has been too long.
Sorry, I don't have better news.
Sincerely,
CCF Neuro MD
Yes, you are correct that the injury was in January 98....I thank you so much for answering me honestly regarding nerve regeneration....you and the other N/S and Neurologists are such a blessing...the work you do blesses so many!! Chin up and on with the show, right....thanks again!
Good morning I had a herniated disc had a partial discectomy on Oct 7 1999 for S1L5.I had a left and central hurniation .I am still having the same pain that I had before the surgey leg, bum, and back pain including numbness in the right foot.I also experienc cold wet fellings in my bum when I sit down and at times in the legs they come and go.I have pain most of the time increased when sitting standing and driving.I also experiencing nerve pain shooting down me leg!!! I saw my surgent the other day and he assures me that all I need is therapy to work on my back muscles!!!! Why have these symtoms not improve with surgey??? I do not feel pain in the area of the sugery any more it feels just like it did before surgery !!!He did a leg raise test and said that there is no nerve problem????Then why all the pain????I am also still taking my tylenol #3 for the pain he wants me to start reducing my meds how will I cope with the pain if he does that !!! I am in so much pain all of the time it even keeps me up at night at times please help desperate in Gloucester!!!!!
Dear Pat Gorman:
Sorry that your experiencing pain. Many times surgery has little effect on the immediate reduction of pain, in fact, unless there is mechanical nerve pain (pain with movement), most surgeries have little benefit except keeping the lesion from worsening. It is still early in the rehab process and I would recommend talking to your rehab team about what you need to do for maximum rehab. I am afraid that pain is something you will have to live with for awhile.
Sincerely,
CCF Neuro MD
Sorry that your experiencing pain. Many times surgery has little effect on the immediate reduction of pain, in fact, unless there is mechanical nerve pain (pain with movement), most surgeries have little benefit except keeping the lesion from worsening. It is still early in the rehab process and I would recommend talking to your rehab team about what you need to do for maximum rehab. I am afraid that pain is something you will have to live with for awhile.
Sincerely,
CCF Neuro MD
DearDr.
I was scuba diving in August 99 when I felt a sharp pain in both ears. Later in the day my ear right ear felt pressurized and I went to the ER. The Dr stated ear infection and provided antibiotics. After 2 weeks my ear still felt different and I scheduled a visit to the ent. ENT Dr claimed I had a retracted eardrum and should be better within 1 month, hearing test should mild hearing loss but was unchanged over the past 3 years. She Rx nasal steroids.
In the beginning of October I still had my ear problems and went back for reevaluation. She said it needed to be given time to heal and It was OK to Fly. She gave me a prescription for .5mg of Zanax to help me sleep at night and calm my anxeity fears. A day later, I was informed that my 6 month old daughter required open heart surgery.
One week later while I was traveling in California I awoke in the middle of the night with fascilations throughout both legs. The fascilations have appeared throughout my body (calfs, upper legs, knees, shoulders, face, forearms) but mostly in the legs over the past month. My arms and legs were stiff and cramping, however, this appears to have diminished. I wrote these symptoms off to being nervous about my ear and my daughters pending surgery, the fascilations seem to come ang go but mostly after I do some sort of exercise ( yard work, lifting boxes etc.)
One week after my daughter's surgery I am still having the muscle twitching. I went to an internist and he Rx Buspar claiming the symptoms were from anxiety. He also gave me selson blue for a slight rash that I developed on my back and chest area. I would like to hear your opinion. Should I go see a Neuro specialist? Thank you in advance.
I was scuba diving in August 99 when I felt a sharp pain in both ears. Later in the day my ear right ear felt pressurized and I went to the ER. The Dr stated ear infection and provided antibiotics. After 2 weeks my ear still felt different and I scheduled a visit to the ent. ENT Dr claimed I had a retracted eardrum and should be better within 1 month, hearing test should mild hearing loss but was unchanged over the past 3 years. She Rx nasal steroids.
In the beginning of October I still had my ear problems and went back for reevaluation. She said it needed to be given time to heal and It was OK to Fly. She gave me a prescription for .5mg of Zanax to help me sleep at night and calm my anxeity fears. A day later, I was informed that my 6 month old daughter required open heart surgery.
One week later while I was traveling in California I awoke in the middle of the night with fascilations throughout both legs. The fascilations have appeared throughout my body (calfs, upper legs, knees, shoulders, face, forearms) but mostly in the legs over the past month. My arms and legs were stiff and cramping, however, this appears to have diminished. I wrote these symptoms off to being nervous about my ear and my daughters pending surgery, the fascilations seem to come ang go but mostly after I do some sort of exercise ( yard work, lifting boxes etc.)
One week after my daughter's surgery I am still having the muscle twitching. I went to an internist and he Rx Buspar claiming the symptoms were from anxiety. He also gave me selson blue for a slight rash that I developed on my back and chest area. I would like to hear your opinion. Should I go see a Neuro specialist? Thank you in advance.
DearDr.
I was scuba diving in August 99 when I felt a sharp pain in both ears. Later in the day my ear right ear felt pressurized and I went to the ER. The Dr stated ear infection and provided antibiotics. After 2 weeks my ear still felt different and I scheduled a visit to the ent. ENT Dr claimed I had a retracted eardrum and should be better within 1 month, hearing test should mild hearing loss but was unchanged over the past 3 years. She Rx nasal steroids.
In the beginning of October I still had my ear problems and went back for reevaluation. She said it needed to be given time to heal and It was OK to Fly. She gave me a prescription for .5mg of Zanax to help me sleep at night and calm my anxeity fears. A day later, I was informed that my 6 month old daughter required open heart surgery.
One week later while I was traveling in California I awoke in the middle of the night with fascilations throughout both legs. The fascilations have appeared throughout my body (calfs, upper legs, knees, shoulders, face, forearms) but mostly in the legs over the past month. My arms and legs were stiff and cramping, however, this appears to have diminished. I wrote these symptoms off to being nervous about my ear and my daughters pending surgery, the fascilations seem to come ang go but mostly after I do some sort of exercise ( yard work, lifting boxes etc.)
One week after my daughter's surgery I am still having the muscle twitching(R). I went to an internist and he Rx Buspar claiming the symptoms were from anxiety. He also gave me selson blue for a slight rash that I developed on my back and chest area. All blood results were normal. I have lost 20 lbs over the past 3 months. I would like to hear your opinion. Should I go see a Neuro specialist? Thank you in advance.
I was scuba diving in August 99 when I felt a sharp pain in both ears. Later in the day my ear right ear felt pressurized and I went to the ER. The Dr stated ear infection and provided antibiotics. After 2 weeks my ear still felt different and I scheduled a visit to the ent. ENT Dr claimed I had a retracted eardrum and should be better within 1 month, hearing test should mild hearing loss but was unchanged over the past 3 years. She Rx nasal steroids.
In the beginning of October I still had my ear problems and went back for reevaluation. She said it needed to be given time to heal and It was OK to Fly. She gave me a prescription for .5mg of Zanax to help me sleep at night and calm my anxeity fears. A day later, I was informed that my 6 month old daughter required open heart surgery.
One week later while I was traveling in California I awoke in the middle of the night with fascilations throughout both legs. The fascilations have appeared throughout my body (calfs, upper legs, knees, shoulders, face, forearms) but mostly in the legs over the past month. My arms and legs were stiff and cramping, however, this appears to have diminished. I wrote these symptoms off to being nervous about my ear and my daughters pending surgery, the fascilations seem to come ang go but mostly after I do some sort of exercise ( yard work, lifting boxes etc.)
One week after my daughter's surgery I am still having the muscle twitching(R). I went to an internist and he Rx Buspar claiming the symptoms were from anxiety. He also gave me selson blue for a slight rash that I developed on my back and chest area. All blood results were normal. I have lost 20 lbs over the past 3 months. I would like to hear your opinion. Should I go see a Neuro specialist? Thank you in advance.
Dear Greg:
I would seek a thorough neurological exam by a good neurologist. Your symptoms could include a variety of diseases, both benign and worrisome. It sounds like you are under a great deal of stress and maybe that is why you have lost the weight, but I would get a physician's opinion that can physically exam you and get the details of your medical history.
Sincerely,
CCF Neuro MD
I would seek a thorough neurological exam by a good neurologist. Your symptoms could include a variety of diseases, both benign and worrisome. It sounds like you are under a great deal of stress and maybe that is why you have lost the weight, but I would get a physician's opinion that can physically exam you and get the details of your medical history.
Sincerely,
CCF Neuro MD
What type of diseases would be possible with my symptoms. I am scheduled to see the internist again on 12/14. I have never really been to see a physician since this all started and I'm only 35 years old. My physical in September was good except for 213 Total Cholesterol. I lost 12 pounds in September, 8lbs in October and has stabilized since then.
I put up over 3500 christmas lights this past weekend, set up a christmas tree and train set, my fascilations appear to have diminished in frequency, just sore muscles after the weekend activities. Also my arms have a slight tremor after excerise for about 1/2 hour. Thank you for your help I really appreciate it
Greg
I put up over 3500 christmas lights this past weekend, set up a christmas tree and train set, my fascilations appear to have diminished in frequency, just sore muscles after the weekend activities. Also my arms have a slight tremor after excerise for about 1/2 hour. Thank you for your help I really appreciate it
Greg
Dear Greg:
The possibilities are endless and would fill up the posting space. The important thing is to rule out the worrisome diseases and that can be done by some simple labs and GOOD neurological exam. Do these things first and then worry if there are things to worry about.
Sincerely,
CCF Neuro MD
The possibilities are endless and would fill up the posting space. The important thing is to rule out the worrisome diseases and that can be done by some simple labs and GOOD neurological exam. Do these things first and then worry if there are things to worry about.
Sincerely,
CCF Neuro MD
Thank you I will set up an appointment for the beginning of
January
January
your welcome.
CCF Neuro MD
CCF Neuro MD
ok you have not had time to reply since I send the last message but since then I have been experiencing alot of numbness in the face alot it is starting to scare me so this is not only herniated disc problems please need a response asap pleaseeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeee
Dear Pat Gorman:
You need to see your neurosurgeon/neurologist. I am not sure what you mean by "you have had time to respond". I answered your posting.
Sincerely,
CCF Neuro MD
You need to see your neurosurgeon/neurologist. I am not sure what you mean by "you have had time to respond". I answered your posting.
Sincerely,
CCF Neuro MD
From my understanding fasculations are either a result of a benign process or a symptom of ALS. Is there any other diseases asociated with fasculations? Thank you for your assistance.
Dear Jamie:
Yes, there are many other conditions that can give you fasciculations. Many of the polyneuropathies, Issac syndrome, infections, muscle disease other than ALS, etc.
Sincerely,
CCF Neuro MD
Yes, there are many other conditions that can give you fasciculations. Many of the polyneuropathies, Issac syndrome, infections, muscle disease other than ALS, etc.
Sincerely,
CCF Neuro MD
Why do myelograms make the injured area more painfull after they inject the dye in you!! I had one done a few days ago and since then I have had alot of pain "nerve" pain in the legs and back pain and starting to have bladder problem loosing control not alot just enough to notice???
You are reading content posted in the Neurology Forum
Find out how beta-blocker eye drops show promising results for acute migraine relief.
In this special Missouri Medicine report, doctors examine advances in diagnosis and treatment of this devastating and costly neurodegenerative disease.
Here are 12 simple – and fun! – ways to boost your brainpower.
Discover some of the causes of dizziness and how to treat it.
Discover the common causes of headaches and how to treat headache pain.
Two of the largest studies on Alzheimer’s have yielded new clues about the disease
