Myelomalacia

[renoguy]

I have some questions about I have some questions about myelomalacia.

A few years ago, I noticed a weakening and lack of full motion in my left leg. I went to neurologist and some tests were run. I was told I had a conductivity problem. At that time a MRI was taken.  I never saw another doctor about my leg after that except as noted below.

In November 1999, I went to NYC and could walk 40 blocks without stopping.

In early February 2000, I went to the Mayo Clinic to resolve a different medical condition. While there, I had the leg looked at. Another group of test were run. According to the neurologist there, I had a demyleniation (sp?) problem between the third and fourth cervical. I was told to have another MRI taken in February 2001 to see how the condition has progressed.

Until the summer of 2000, I never had any pain with this.

In early summer 2000, I notice I had even less motion in my left leg (I can raise my right leg to 90 degrees about the floor, my left leg about 15-20 degree). Also while working out at the gym, I noticed I could more 3-5 x the amount of weights with the right arm/leg than I could with my left arm/leg. I have also noticed some balance problems.

Starting in the middle of the summer, I also noticed that it was getting difficult for me to walk/stand for any length of time. Until then, I could do 45 minutes on a treadmill. Now, I can only walk one or two aisles in my grocery store before I had to sit down from the back pain. Now I have back pain constantly, a pain in my left knee, and pain in my left arm, and pain in my left foot. Also the left side of my neck feels different from the right; as if it were swollen.  I am also starting to have balance problems (at least once a week I catch myself as I am about to fall) and my wife noticed I am occassionally slurring words.

After talking to my personal physician, she decided to run another MRI early. This MRI said I had

[CCF Neuro[P] MD, RPS]

Dear Renoguy:

Without seeing the films I am not sure I can help.  First, the initial MRI in (?-"a few years ago") must not have shown anything, am I correct in noting that?  Therefore even though you had symptoms, there was nothing on MRI to suggest a problem with your C-spine.  Obviously, your symptoms fit the recent MRI findings.  Surgery, may or may not help symptoms.  If the disc herniation is really compromising the cord, then surgery would relieve the compression.  If the demyelination is due to another cause, such as acute demyelinating encepholmalacia (ADEM) or some other demyelinating disease, then surgery will likely have little effect.  Actually, your description does not sound like it is the disc inducing the problem.  What did the EMG show?  I would also do evoked potentials to see where the lesion might be occurring.  I would get worked up neurologically before you decide on surgery just yet.

Sincerely,

CCF Neuro MD

[renoguy]

I should have stated that when I was at Mayo, I was told Ihad a COMPLETE nuerological workup. Amongt the things done to me as (1)  dodads (sorry I don't know the technical word) attached to my head while I looked at lights,and (2) I had an EMG (I had pins stuck in my body while I recieved electical shocks,)

I was told everything was normal except for the demyelination problem.

RENOGUY

[CCF Neuro[P] MD, RPS]

Dear Renoguy:

The trouble with the internet is that I can't look at the MRI or do the neurological exam.  From what you told me, the disc herniation does not seem like to culpruit that is causing your progressive problem.  But, with all else normal, I am having some difficulty trying to come up with an alternative explanation.  I am sorry.

Sincerely,

CCF Neuro MD