Myelopthy and Seizure

[SamScott]

Hello - I've just been diagnosed with Cervical Spondylotic Myelopathy confirmed through MRI, CT Scan and presence of Hoffmann's sign.

My symptoms began after a seizure in late 2004 (my first and only) while recovering from my second shunt revision within 1 year.  Symptoms at first were very gradual but now progressing.

Is there a possible cause/effect between the siezure and the myelopathy.  

Any feedback would be greatly appreciated!

[Joanna Fong, MD]

Hi SamScott,

It is unusual that seizure causes myelopathy.  Seizures typically originate from the brain.  Myelopathy is problem with your spinal cord.  In your case, it is the neck part of the spinal cord.  

Cervical spondylotic myelopathy is the most common cause of myelopathy (spinal cord dysfunction) in adults over 55 years, causing progressive disability and impairing quality of life.

Cervical spondylosis refers to a progressive degenerative process affecting the cervical vertebral bodies and intervertebral discs. This process can lead to narrowing of the central spinal canal, compressing the cervical spinal cord and producing a syndrome of spinal cord dysfunction known as cervical spondylotic myelopathy. Myelopathy occurs in 5 to 10 percent of patients with symptomatic cervical spondylosis. Other clinical syndromes associated with cervical spondylosis include neck pain and cervical radiculopathy.

There is no specific stereotyped presentation of cervical spondylotic myelopathy. Usually symptoms begin with an insidious onset of gait disturbance. Other common symptoms include sensory loss, and weakness and muscle atrophy in the hands along with and neck and arm pain. The examination usually reveals other myelopathic features (such as your Hoffmann's sign).

The clinical course and prognosis of cervical spondylotic myelopathy is not well characterized. Patients can deteriorate progressively or in a step-wise fashion with long periods of stability. Some patients may deteriorate abruptly in association with a minor neck injury.

For patients with mild, nondebilitating myelopathy we suggest surgical consultation for those at risk of neurologic deterioration. Close neurologic follow-up should assess for deterioration when surgery is deferred. Conservative measures include intermittent neck immobilization, pain management, and restriction of high-risk or aggravating activities. For patients with more severe myelopathy or progressing deficits, we suggest surgical decompression.


I hope that's helpful.  Thanks for using MedHelp.

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[SamScott]

Thanks for the tip!

[SadieSunflower]

Have you had your B12 levels checked? This is just one case in India, but you could do more research to see if this holds any water. In any case, it can't hurt to check your B12 levels. He is the article.

http://www.neurologyindia.com/article.asp?issn=0028-3886;year=2004;volume=52;issue=1;spage=122;epage=123;aulast=Kumar