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Neurology (Expert Forum)
Acute cervical spondylosis
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Acute cervical spondylosis
by rencei, May 31, 2005 12:00AM
I’m a 35 yr. old female who has been on a roller coaster ride seeking a diagnosis and treatment of my symptoms. My symptoms began in Dec. 2004 and diagnosed as paresthesia due to a pinched ulnar nerve. By my first appt. with a neurologist in mid-Jan. my whole left hand became numb on a constant basis. After an EMG and NCV, the results showed early carpal tunnel. By the end of Feb. My left and right hand and arm became numb, weak and painful on a constant basis. My neurologist began to think it might be MS or transverse myelitis. I had a series of MRI’s, a Lumbar puncture, SSEP’s, VEP’s, and BSAEP’s. All of these results came back normal. Since the end of April my feet and legs have become weak, heavy, numb, and at times have sharp pains. My D.T.R.s show hyperreflexia bilaterally quads and bilaterally A.T. and equivocal Babinski signs bilaterally. My ability to walk has become compromised. And at times I am unable to move my legs and arms much at all. I finally had a neurosurgery consult after a visit to the E.R on May 3. I was told that my diagnosis is cervical spondylosis. I have been waiting to have the cervical fusion. My symptoms continue to get worse and I’m told that I have to wait until the end of July to have this surgery scheduled. I notice that when I put stress on my neck when I try to perform daily activities such as driving, cleaning, and computer and yard work, my neck aches, I develop a severe headache, and aggravate my other symptoms. I recently started to fall due to my legs buckling under me. The neurosurgeon has not given me any guidelines on what I should or should not do until the surgery. My fear is that permanent damage might be done. I have stopped all of my regular activities and feel like a prisoner in my home. I have called every neurosurgeon in the city of Jacksonville, Fl and noone is able to help me. Do you have any suggestions and advice to give me? Thank you.
Doctor's Answer
by CCF-Neuro-M.D.-PW, Jun 01, 2005 12:00AM
While your hand symptoms may be contributed to by carpal tunnel, your other symptoms would suggest a myelopathy (or spinal cord lesion), of which one of the most common cause is cervical spondylosis (usually from wear and tear of the cervical vertebrae and discs)
The EMG and NCS will not show a myelopathy other than reduced activation of motor muscle fibers and carpal tunnel is a common incidental but inconnected finding.
Its not clear to me if the spondylosis was diagnosed by MRI, I presume it was. I cannot comment on the severity of the spondylosis and as to how much the spinal cord is pinched without seeing your MRI, so my advice as far as reccomendations for surgery is limited. Wearing a soft neck collar at night or at other times if it benefits your symptoms can help prevent worsening and be more comfortable for you. There are no specific reccomendation other than avoiding excessive physical activity and neck stretching such as roller coaster rides or painting the ceiling. Physical therapy can be beneficial - it is important to keep conditioned and flexible as possible in your limbs until a surgical procedure can be done. Surgery will prevent the problems getting worse, but it may not reverse what is already there - that is up to the body to heal itself over time
If no abnormal signal within the spinal cord was present, that is a good sign that nerve damage has not occurred too severely.
GOod luck
The EMG and NCS will not show a myelopathy other than reduced activation of motor muscle fibers and carpal tunnel is a common incidental but inconnected finding.
Its not clear to me if the spondylosis was diagnosed by MRI, I presume it was. I cannot comment on the severity of the spondylosis and as to how much the spinal cord is pinched without seeing your MRI, so my advice as far as reccomendations for surgery is limited. Wearing a soft neck collar at night or at other times if it benefits your symptoms can help prevent worsening and be more comfortable for you. There are no specific reccomendation other than avoiding excessive physical activity and neck stretching such as roller coaster rides or painting the ceiling. Physical therapy can be beneficial - it is important to keep conditioned and flexible as possible in your limbs until a surgical procedure can be done. Surgery will prevent the problems getting worse, but it may not reverse what is already there - that is up to the body to heal itself over time
If no abnormal signal within the spinal cord was present, that is a good sign that nerve damage has not occurred too severely.
GOod luck
I’ve been to hell and back for 14 years and the one thing I have learned is “never” give up. Keep pushing your docs for answers and if you don’t feel you are getting the right ones, find another doctor. My family doctor of 24 years told me 14 years ago “you are the chairman of the board of your health, you need to be involved in your health decisions and find the right doctors to help you.” How true his words were and are and fortunately I today consider him the CEO of my health. Having a great family doctor in my opinion is one of the best things you can do for you. If he is good, he will help you navigate your way through the medical community which in itself can be overwhelming.
Best of luck to you.
I do plan on seeing if there is any legal recourse and determined to make some noise and to be heard. Good luck to all of you.