Hello doc. I have this problem of spontaneous random vertigo that lasts from several hours to days at a time. Also, I have this feeling of tension across my scalp, especially my forehead. This feeling of tension is greatly increased when I lift weights...even if I'm just working out my legs. I've had an MRI contrast brain scan, normal, and an MRI non contrast cervical spine MRI, normal. A previous poster asked a question and you mention something about neck problems can cause vertigo and other issues. I realized that when I manipulate my upper neck at various extreme angles that the tension in my scalp seems to ease up. I also hear this odd squishing sound from the back of my head/cerebellum area when I move my head around even a little. So my main question is how could I be more thoroughly evaluated for neck issues given the "normal" MRI scans? Would a thin sliced CT of the neck be good? What is being missed, how would you proceed in the hypathetical scenario that I am your patient?
When neck pain due to muscle spasm/tension/ligament and joint pain the MRI is usually normal or shows some degenerative disease. In this setting there is no utility to the MRI or CT or any other imaging other than ruling out serious causes ie masses or tumors. One cannot 'see' pain or the cause of pain in most cases on an MRI or CT scan because they have their own limitations in what amount to details they can show. Nothing is being 'missed' because imaging is not going to tell you the answer anyway. The diagnosis is a clinical diagnosis supported by 'normal' imaging studies.
Further evaluation is based on a detailed and specialist physical therapy examination of the neck, and response to treatment.
I cannot give you specific reccomendations for your case, but in general this is the scenario for patients with 'cervicogenic headache'
I had identical problems, and went to an ENT specializing in vertigo and tinnitus (ringing in the ears). He told me I had cervicogenic vertigo, coming from dysfunction in my neck muscles, probably from bad posture and so forth. Your brain relies on signals from your scalenes and sternocleidomastoids and other neck muscles to figure out the position of your head. If your neck muscles are weak, cramped, have trigger points, etc., your brain gets incorrect signals and you get dizzy. I'm getting trigger point massage therapy, and I'm going to start seeing a physical therapist soon. The massage has already made me start to feel better.
Listen to the doc, but I'd visit an Ear, Nose, Throat guy who specializes in vertigo and tinnitus and ask if this is happening to you.
I have a comment about headaches and vertigo. I had a herniated disk between C5-6 and am 6 months postop ACDF. I have improved SLOWLY. Three months post op I started experiencing vertigo. I saw an ENT who also diagnosed me with Cervicogenic Vertigo, which is a latent symptom of the neck injury. The vertigo always accompanies the headaches which feel like they come from the back of the neck to the forehead and feel as if my head's going to blow off. With rest and an analgesic I get through it. I have weaned myselft off the prescribed painkillers to over the counter aides. It was difficult and took two weeks but I did it. I still have bouts of pain that is directly related to activity. The pain is my indicator to slow down. My life has changed incredibly but at least I am not in CONSTANT pain. For those of you out there going through this my heart goes out to you. I know what it means to live with Chronic pain for almost a year. Hang on.
I've lived with various horrendous symptoms resulting from this problem for 20 years. in the last five years, its become near impossible to cope with. Symptoms have included virtigo, headaches, parasthesias all over body, vision problems, muscle twiches, gait problems, speach problems, severe thoracic pain (yes, this was caused by my neck, which put everyone off the scent that it was a neck problem) head pressure and chronic fatigue to name just a few - there are many more odd ones that are also tied in like bldder problems etc.
I've tried so many different alternative treatments as the docs never could give me an answer and there meds had side effects that I couldn't live with either. I've wasted thousands on so called miricle cures like magnetic sleeping pads with no improvement. Physical therapist recently said I was just unfit and depressed and ordered me to get on her exercise bike which resulted in a massive 4 day migraine.
I had an MRI as they were sure it was MS and this was normal - I felt upset that I could go through all this and be told I was normal!
Recently I decided to try yet another Osteotheripist and he has changed my life. Trigger point massage as Steve mentioned, or the osteopathic equivelant the is definately the way to go. Osteo says that my Atlas joint - where the skull meets the spine, is jammed and squashing the nerves that pass through it. Its not something that can be fixed overnight and at first the treatment caused a major worsening of my symptoms (He says that this is why noones fixed it before - because they backed off when I got worse) but in the last couple of weeks I have noticed some major changes. Thorasic pain that previously burned has nearly dissapeared, virtigo has reduced etc etc.
To the previous poster - learning to live with it is good for you in some ways, but don't give up on a cure. I gave up for the first time (on the doctors advice) early this year and I felt so low.
Try osteopathy or similar, but don't let them adjust your neck as many of them want to do - it only brings very temporary relief and then makes things worse - think of what it must do to those poor nerves already caught up in there. It was an adjustment that pitched me into hell last year and brought about the whole 'you've got MS' fiasco. I will never let anyone do that with me again. From what I've seen, there is no real quick fix, but for the first time ages, I feel like I'm on the right track.
Hi, yes, I've had sensory symptoms all over my face and body and I know what you mean about the chilled feelings. My toes still buzz 24/7, so I hope the osteo treatment will help with that.
I asked my neuro months ago if this could all be caused by the neck, and he said no - because the MRI did'nt show anything - since then, many in both the medical and alternative therapy proffessions have told me thats not true - that it wouldn't have shown up on the MRI - and now the Neuro on this thread has said the same - I feel a little annoyed as I could have got help much sooner. So you may not get the answer you're looking for - you may just need to bite the bullet and go to see an osteopath or similar. Good luck.
I too have had lightheadness/dizziness issues for 10 months now, following a head injury. I donated blood, passed out and hit my head/neck. I have had to since quit my job. I have seen a neurologist, neuro-tologist, osteopath, ENTs, and have been to a balance center including vestibular therapy sessions. I have had 2 cat scans, and an MRI. They have found nothing out of the ordinary short of some minor enhancement of my facial nerve on the right side. I started seeing a dentist specializing in TMJ issues. I have heard seeing a physical therapist specializing in TMJ may help. My symptoms include numbness in my fingers/forearms, tinnius, dizziness, lightheadedness, chronic fatigue, feelings of flushedness in my upper body including my face and head, constant bloodshot eyes, pain and throbbing off and on in my ears, jaw, and lower back of my head. I had an adjustment with an osteopath today but really no change so far. I have appointments to see the dentist again, and I have not yet scheduled any therapy. Any directions I have not looked into or questions to ask these specialists would be greatly appreciated. Thanks in advance.
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