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Spinal Cord Disorders Message Board

Spinal Cord Disorders Board Index

I am at my wits end. I have been living through some of the hardest days of my life and am being told there is nothing that can be done. My family doctor is spearheading a request to Lahey Clinic in Boston. I would love to hear peoples thoughts. I am missing work (am able to work @ home) and this is now impacting my status at work. They are a great company and will work with me, but with no diagnosis what are they going to think?

Doctors seen:

Neurosurgeon feels that even though there was a noted cord issue, there was nothing that a surgeon could do. When my wife and I pressured him he said there possibly could be a bone spur that is causing issues, but it’s not showing up thus, not operable at this time

Neurologist feels that while I hit high on MS symptoms, my whole CNS was tested and shows nothing. No vision change, urgency and frequent urination, but I also have a slightly enlarged prostate.

Rheumatologist is trying to keep arthritis down.

Daily Symptoms: (these have been occurring for 6 months and have been gradually getting worse)

Weakness (uneasy, tingling) in both legs. Shocks (depends on body position, action, etc) in hands and spine, this occurs more in hands/arms than spine and more prevalent on Left Side. I am not sure if its related to this or the drugs, but it is becoming difficult to do detailed tasks. Typing for example I can be doing fine for few mins then the hands get shaky and fingers hit wrong keys…consistently off sometimes where 3-5 tries is needed to click the one proper key. Other somewhat simple tasks are becoming more difficult. In the legs I have had a few moments where one or both have disappeared and I needed 100% of cane, walker or whatever is near me.

Pain in lower back (dull pain all the time) when walking or standing more than 100ft/10 mins becomes debilitating and I cannot stand upright at all. This condition has put me on a cane and walker for around the house and to and from car.

Pain in upper back and neck (dull to severe every day). This causes severe headaches which last 2-5 days (ranges from clavicle to base of head towards ear and sometimes also causes earache), reduced to no range of motion in neck and upper torso during this time . I have what I have been called “flair ups”, these cause extreme disability, pain multiplied tenfold and minimal relief from Vicoden. These seem to come on from activity and I have to plan my activity with the down time it causes.

Hyperreflexes with Clonus both legs and Tremors/convulsions or shakes through lower body and sometimes whole body. They become worse with activity also (I get tired and weak) and rest, they come on strong and more severe. These seem like a startled type of a reaction followed by several smaller tremors. The Gabapentin appears to help slightly. I can only take 100mg per dose and no more than 3 doses(300mg) per day. Dr. wanted me to try upper doses with 300mg dose x3, which made me very unsettled, loopy and had to reduce. These I feel are from the hyper reflex actions the Dr’s are seeing. I am so sensitive when I take a shower, the water hitting my legs makes me feel weak. Certain long pants and even the sheet and blanket feels like they weigh a ton. If I sit with my thigh with too much pressure the clonus/reflex makes leg go crazy. Its like I cannot feel comfortable unless something is moving or shaking, muscles are constantly being flexed (tremors) and by mid day I am sore, I am constantly injuring my back due to this. My wife says my leg or foot moves even when I sleep.

Night sweats almost every night.

Other Symptoms: I had a few times where my upper lip went numb(like I came from dentist). I had the tremors go non-stop for 2-3 hours a couple times, the pain and energy loss afterwards was incredible.

Tests to date: (From reports, don’t know what these mean)

MRI with and without Contrast: (focus pain neck and leg left side)
No contrast
Loss of cervical lordsis which may be due to spasm or positional
Intevertebral disc height @ C6-7 is slightly decreased
Neural forminal narrowing on right C6-7 seen in oblique views
The other neural formina appear patent
The pre and paravertebral soft tissues are unremarkable and the lateral masses of C1 and C2 are normal. No cervical ribs are seen.
Impression: Evidence of mild narrowing on the Intevertebral disc at level of C6-7 and right sided neural forminal narrowing, probably secondary to degenerative change. Loss of normal lordosis in the cervical region which may be due to muscle spasm, no evidence of fracture is seen.

Small prominence of left side intervertibral disc at T11-T12 (finding is compatible with small disc protrusion)
L1-L2 there is minimal bulge of annulus and slight facet arthropathy
L2-L3 there is minimal bulge of annulus at L2-L3 and slight facet arthropathy
L3-L4 there is a minimal bulge of annulus at L3-L4 and slight facet arthropathy
L4-L5 there is minimal bulge of annulus at L4-L5 and slight facet arthropathy
L5-S1 there is a prominent bulge of a degenerated intervertrbral disc L5-S1 which is focally prominent centrally and to the right. There is also mild facet arthrophy on the left. There is also a slight thickening of the ligimenta flava.

Another MRI (focus on stenosis)
C2-C3 Contour is within is within range of normal variation
C3-4 small disc osteophyte complex. There is minimal effacement of the anterior subarahnoid space.
C4-C5 There is an increased signal in the neural foramen on left C4-C5. This may reflect partial volume averaging of a prominent uncinate process of C5 on the left as well as possible disc protrusion. There is evidence of some compression of the C5 root on left. The neural foramen on the right is widely patent.
C5-C6 There is small disc osteophyte complex. There is bilateral bony foraminal encroachment
C6-C7 There is broad based disc osterphyte complex. There is effacement of the anterior subarachnoid space. There is bilateral bony foraminal encroachment.
C7-T1 There is broad based disc osterphyte complex. There is minimal effacement of the anterior subarachnoid space

There is anatomical alignment and position of the vertebral bodies and posterior elements. There is no acute compression fractures. There is minimal chronic wedging of the T9 and T10 vertebral bodies. There is also a slight decrease in height of the T8 vertibral body. There is a disc osteophyte complex at T9-10 and at T10-11. The dics osteophyte at this time are not prominent. However the contour of the thoracic spinal cord is mildly flattened and there is some slight focal cord atrophy at the level of T9-10. There is a suggestion of some increased signal in the thosacic spinal cord at level T9-10. The Thoracic spinal cord has a more normal contour at T10-11 and there is no evidence of abnormal signal in the thoracic intervertibral discs are within the range or normal variation. There is no extramedullary intradual abnormalities. There is no evidence of pathological replacement of the normal fatty marrow

Moderately severe spondylosis at T9-10. There is some minimal wedging of the T9-10 vertibral bodies. There is disc osteophyte complex. The contour of the thoracic spinal cord is slightly flattened at this level and there is suggestion of some increased signal. These findings appear chronic in nature. There is no evidence of acute compression of the thoracic spinal cord at this level. There is also a small disc osteophyte complet at T10-11. There is no contour abnormality signal in the thoracic spinal cord. No other positive findings are identified.

CAT Scan with/wo Contrast (Brain)
Normal CT of Brain the noted prominent external occipital protuberance is normal anatomical variation

Both hands/arms slight carpel tunnel, legs, feet no issues.

Bone Scan
Degenerative arthritic disease in knees, sternoclaviclar joints and thoracolumbar spine.

Myelogram with contrast (no fluid test)
Normal thoracolumbar myelogram (did see a rounded mobile filling defect is consistent with an air bubble)

Spinal tap (scheduled) to test fluid for MS markers

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