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Forum Name: Neurology Topics

Question: Undiagnosed Multiple Neuro Symptoms

monarog - Sat Jan 06, 2007 4:49 pm

I am a 45 year old female, was a very active runner, until all of the neurological symptoms hit 10 months ago. 16 months ago I had a large paracentral cervical c6-7 disc herniation - no surgery. My pain improved for 4 months, then pain worsened and within 6 weeks many horrible neurological symptoms hit me, went to the ER. A new cervical MRI showed the disc to slowly be reabsorbing, but the pain that had left my arm returned, intense Neck pain and now for the last 10 months the following neurological symptoms have been unrelenting, they wax and wane and move around. All tests have been normal including: Brain MRI w/ contrast, Lumbar Puncture, EMG/NVC, extensive blood testing (Lyme, vitamin deficiencies etc), MRI of thoracic and lumbar regions. The only notation by 3 neurologists I've seen is my reflexes are brisk and my BP is now slightly elevated, when it was always low. I take Ibuprofen constantly for the pain, and Trazadone sometimes at night to help me sleep. - Dizziness, off balance feeling - Muscle twitching, fairly body wide - Nerves to arms and legs feel charged, over active all the time, when this feeling is really strong has caused my hands and/or legs to tremor - Tongue often burns, is red, sometimes feels swollen and irritated, no swallowing or speech difficulty - Twice had bilateral facial numbness - Numbness in feet, up to ankles at times - Neck/arm pain The hardest to tolerate is the "plugged in" nerve feeling; it's VERY uncomfortable. I'm at a loss for what to do, I've seen 3 neurologist, 1 Rheumatologist, have an appt coming up with a Physiatrist. I feel sick every day. Could the MRI be missing something in my neck? It feels all about my neck, but no one seems to think this is the culprit, but me. I appreciate advice/direction.

monarog - Sat Jan 06, 2007 4:51 pm

Sorry, meant to add, my cervical MRI shows narrowing of can to apprx. 10mm at herniation site...is this problematic?

John Kenyon, CNA - Fri Jan 12, 2007 7:54 am

Hello monarog - Almost everything you describe could eventually be connected to a C-6, 7 herniation with nerve outlet compression (except, perhaps, for the red and burning tongue, and that's not out of the question). The dizziness and off-balance feeling could well be cervical vertigo, and the neck and arm pain can go into remission only to return periodically. As the disc resorbs it changes the dynamics of the injury and so new sypmtoms can sometimes arise as you have described. You didn't mention how you came to have this herniation. Was it the result of some sort of physical trauma? Or did you just start having symptoms slowly and insidiously? Oh, and as for the increase in BP, two things are probably conspiring to cause that: one is chronic pain, which is a stressor quite able to increase blood pressure. Also, chronic use of ibuprofin has been reported to be associated with increases in BP in some paitents as well. You might want to rotate off to something similar, like naproxyn sodium (Aleve or Naprosyn). The muscle twitching (fasiculations) are often seen with nerve irritation and the narrowing of the CAN at the site of the herniation is what I meant by "changing the dynamics." It could be problematic, yes, as pressure could be brought to bear on a nerve outlet. The numbness in your feet is sometimes seen in cervical injuries (neuropathy) and all together suggest a possible bilateral nerve root compression at the level of the herniation. One possible therapeutic approach would be a series of at least three epidural steroid injections at the site of the herniation, which sometimes provides dramatic, if temporary, relief. Have you had a consult with a neurosurgeon as yet? That would probably be the next logical step in trying to determine the best way to manage your problem, which could wane again, but is not likely to resolve itself long-term. Hope this is helpful to you.

monarog - Fri Jan 12, 2007 3:21 pm

John.... SO HELPFUL....thank you, thank you! I did not injure my neck. I had that "slept on it wrong" feeling for a couple of months that never went away. Then in the middle of the night, bam, just horrible, horrible pain which sent me to the doctor. I have seen a NS. He is VERY conservative and is one that does not use epidural injections. The problem is I am miserable and need some relief. I am going to consult with him again and if I don't get anywhere I will have to seek someone else out I guess. It's been frustrating as it seems when you don't "fit in the box" with your symptoms, then the doctors want to send you on your way with no symptom relief. I could tolerate the pain, but all of the weird neurological symptoms are the worst; I feel on edge all the time along with my list of everything else. I would have loved to be one of the patients who rupture a disc, it reabsorbs with improvement, and then I go merrily on my way. Unfortunately, that has not been my case. I had no idea it could mess me up this terrilbly. Anyway, I appreicate your response. I will be seeing a Physiatrist in a few more days; I'll see where that gets me and then discuss revisiting my NS or another NS about this. It's been going on for a year and a half now. I use to run 25-30 miles weekly and I miss my previous healthy life. This has all been very humbling, to say the least. Thank you so much for your information John. Sincerely, Mona

John Kenyon, CNA - Wed Jan 17, 2007 6:38 am

Hi there - Well your experience just goes to show it doesn't take a huge trauma to sometimes injure the cervical spine. This happens, although it is rare. There may have been some congenital weakness or really old injury that had set this up and it finally just shifted in the night. It's always hard when one winds up with a presentation that falls "outside the box." Neuro symptoms especially can be infuriating for all concerned. Hopefully the physiatrist can help throw some light on this, or maybe your NS will reconsider and this will get cleared up sooner than later. Meanwhile, even though you aren't able to run like you used to right now, by all means continue to do as much as you can to live healthily. Please keep us updated.

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