Need a diagnosis

[betth]

I was injured five years ago by a violent student.  I was the only one trained to restrain the young man, who was 19 and had autism.  His favorite place to aim his hits were to the head.  One week I was hit every day, and went home that Friday in a lot of pain.  The next day I was driving in my car, and my left hand and arm curled into my body (my left hand curled tight into a ball.) My body curled over and I was in horrible pain.  I tried to relieve the pain by going to bed (I thought I had muscle spasms,) but couldn't move.  The  next morning my husband took me into the dr..  Eventually, I had an MRI of the spine, which showed that I needed surgery on C5-6 and C-7.  I was told after  the lamenectomy that my arm and hand would be fine.  They weren't.  The dr. I saw didn't xray or MRi my shoulder or hand....I was given a little OT/PT.  The OT said that I had hypertonicity in my hand, and I saw some improvement with  therapy.  The case was quickly closed by workman's comp. They told me my arm and hand would be okay in two years.  They weren't.  A year ago I again went to a neurologist, a shoulder dr., and a hand surgeon.  I have had nerve testing which showed an old injury to the C-7 nerve.  It also showed that all nerves were normal at rest, but when I  tried to move them they were all abnormal except for the brachia and deltoid muscles.  There were also abnormal motor patterns in all muscles except the brachia and deltoid.  The hand surgeon said that there is a break in every motor system in my hand.  The xray of the shoulder showed that the ball of the shoulder had rotated up with the muscles in the front and back of the shoulder very small.  He wanted the PT  to strengthen these muscles, but she said that my shoulder was like that because of hypertonicity.  She said that to strengthen the muscles would only increase the tone.  The OT and PT say I have hypertonicity and continue to ask if I had a stroke. My hand has limited use as I cannot straighten my fingers and my hand is hypertonic. They have referred me back to the  neurologist who said that they didn't see tone.  The neurologist said I had a frozen shoulder, but the OT, PT and shoulder surgeon said that that this is an incorrect diagnosis.  All the drs. say that this cannot be a result of the pinched c-7 nerve, but have no diagnosis.  Can anyone help with ideas?

[sonu78]

Hi,
Can you explain the movements possible with the range across all your joints both actively and passively.
As I still vouch for injury to the brachial plexus .

[betth]

He did the lamenectomy on c6-7.  He then gave me a little OT/PT.  The OT looked at my hand and said that I had high tone, and that it needed to be a central nervous system injury.  The dr. (who works a lot for workman's comp) quickly closed it.  He did no other MRI's (in fact he didn't do the first one.)  He didn't image my shoulder or do the nerve testing.  He just said that I'd be better in two years.  I'm not.  The other testing is recent.  It's been five years since the injury.  I've been working for the last year to get a diagnosis.

[sonu78]

Hi,
What did the neurologist advise at the time of the incident. Did you undergo MRI of the spine focusing the cervical region and what did it report.

[betth]

Thanks so much for your comments.  I thought that it might be the brachia as well but the nerves of the Brachia were one of the only three systems that were intact in the nerve conduction test.  I thought maybe there was a Long Thoracic Neuropathy, but don't have winging of the scapula which I think that diagnosis involves.  I have been told by OT and PT that they believe there is CNS damage....maybe to the spinal cord or brain.  The MRI of my brain came out normal, but I am unsure if there was a small bleed if it would be detectable five years later.  When I was originally hurt the neurologist only looked at my spine.  In fact it was only this summer that anyone even imaged my shoulder!

[sonu78]

Hi,
Your case sheet history suggests some pathology to the brachial plexus of the limb(Nerves). Supposedly you had laminectomy 2 years back but that did not help.
Now I would discuss your case a fresh.
Possible working diagnosis -- Brachial Plexus Injury
In this you should understand that there must be some damage to the nerves. Could be that you may have a bad scar at the level of neck leading to nerve damage.
For this you require exploration but feel that it is little late. But still can be done.
Hence consult a Plastic surgeon  at the earliest.

[theorganizer]

did you have a brain MRI? is there a particular part of your head that keeps hurting?