At Neuro Today: Clinical weakness, atrophy, abnormal EMG

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Re: At Neuro Today: Clinical weakness, atrophy, abnormal EM

Postby Xina535 on April 17th, 2015, 1:16 pm

Yuliasir wrote:I wonder how could it be a bad sign if a drug designed, among other, as neuropatic pain killer, helps you with the pain :)))


I know - sounds stupid. Is stupid. My brain isn't working that way right now. I don't care about the pain or it going away. I want to know that IF this medicine is helping with the pain, THEN does that mean I indeed have a neuropathy and not headed towards...you know.

Meaning - the pain I am having is neuropathic and not related to muscle cramps/stiffness/spasticity (muscle-skeletal pain - that could maybe come up in MND)?

If that makes any sense, probably not. I feel lost right now. Remember my left leg issue, when I fell down the stairs and it was giving me issues? It's coming BACK! I'm starting to walk weird again. I can't take all of this. :cry: :cry: :cry:
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Re: At Neuro Today: Clinical weakness, atrophy, abnormal EM

Postby Yuliasir on April 17th, 2015, 1:36 pm

you practically do not need to benchmark your pain gainst gabapentine to know whether your pain is neuropatic.

neuropatic pain is extremely specific. It is described as burning, stabbing, tingling, itching - or - as your perfectly described - as extremely painful touch sensation.
it has really nothing common with the pain from spasticity (if you had labours, you may remember what is a spastisity pain - it is pulling and muscles become hard, and the whole limb takes weird and forced position until cramp is not releived. Inflammation pain is also well known and you may had it zillion times during viral infections.

but neuropatic pain... it is like a flame under the skin. by the way, thing like ibuprofene usually do nothing with that. Your experience and descriptions seem to saying cleary that your pain is neuropatic.
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Re: At Neuro Today: Clinical weakness, atrophy, abnormal EM

Postby Xina535 on April 18th, 2015, 10:34 am

Yes, exactly. Ibuprofen did nothing. This gabapentin is helping. I was so worried that the pain I was having was like because of muscle cramps and stiffness (like when you work them out, they burn). But if gabapentin is helping the pain, also in my neck, then it's a neuro pain.

Coming back to the herniations. Am I crazy? I found that the deltoid muscle (the one that is damaged which was EMG'd) is innervated by the axillary nerve. All brachial plexus maps I've seen on the internet show that the axillary nerve stems from the C7 nerve root, and even branches/connects with C6. The neuro said he doesn't think what is happening in my arm has to do with the herniations because they are "too low" and he would expect C4/C5 compression to map to my arm problems.

Again, my MRI said this below (remember, this is the moment of laying comfortably in an MRI machine with a good neck support and no pain at the moment of MRI). Am I crazy,or totally overlooking something? Even the radiologist who took the brain MRI said that there is a significant herniation to the left and in his opinion is causing the problem in my arm.


MRI:


Cervical spine in steep position. In segment C5/C6, vertebral disc prolapse subligamentous with a deep expansion of 2,5mm with protuberance of the dural sac. Free foramina. No clear affection of the root.

At C6/C7 left eccentric circumferential vertebral disc herniation with relative recess stenosis left and initial short segmented “retrospondylophytär” (retrospondylolisthesis??) crashed components also in Neuroforamen of the right side. Also here, no compression related Myelopathy findings. No vertebral height reduction. Relevant paravertebral abnormalities are not shown. No “unkarthrosen” (uncarthrosis??)
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Re: At Neuro Today: Clinical weakness, atrophy, abnormal EM

Postby Xina535 on April 20th, 2015, 3:42 am

Just writing to let you know I posted about my visit to the neurosurgeon today in the thread below. He does not believe my arm problems are from my herniations.

viewtopic.php?f=4&t=21539&p=162022#p162022

FUP visit with normal neurologist this Thurs to go over everything. Maybe he'll do more tests.
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Re: At Neuro Today: Clinical weakness, atrophy, abnormal EM

Postby Xina535 on April 28th, 2015, 3:37 am

and an update for everyone (I also posted this in another thread "Twitching - Healing or Dying"?


I've been PMing some people, but I wanted to post the different opinions from the neuros on here for everyone.

The professor neuro saw me. And I also saw my normal neurologist last week as well.

All 3 neuros, and the neurosurgeon agree that the herniations in my cervical neck are not the cause of what is going on in my shoulder/deltoid/arm. The herniations at c5/c6 and c6/c7 are too low to affect my deltoid and shoulders. All diagrams I see online show that the deltoid is c5/c6 level, so I don't get it, but I will accept their opinions.

The professor neuro and my normal neurologist told me that the neuro that diagnosed me with Plexus Neuritis is wrong.

Normal neuro said: In plexus neuritis, I would have a limp arm and definite atrophy, which I don't have (something my husband and I wondered about too, we don't see any atrophy and thought the neuro could see something we don't). He took blood for lyme disease (results this week). When I asked him if it is not plexus neuritus, and not related to my herniations, then what is going on? He literally said, "I don't know either." I asked him what he thinks about my abnormal EMG and he said: "Anyone could have those results." :?: :?: :?: He did not look at me, did not examine me, nothing. He said the neuro should have never put me on cortisone. After this lyme test result comes back, I am never going to him again.

Professor neuro: Did a clinical neuro exam (no EMGs or anything), strength is still there. He said the same thing about plexus neuritis and could see that I have no atrophy in my shoulder. He said in 30 years, he's seen maybe 5 cases of this, and I don't have it. He said the EMG of the other neuro showed findings, but it could very well be that something attacked me, but that I have my strength back, that I am getting better. He said the cortisone was a good idea. To keep taking gabapentine, taper off the cortisone as planned and continue physio.

Both the professor neuro and the normal neuro, and now my primary care doctor, think it could be something attacking me or something auto-immune. My primary care doctor is going to re-order the blood tests after the cortisone is out of my system. I will start acupunture with her for my shoulder/arm (since the pain is still very high) and she will also give me an infusion of stuff to help nerves heal.
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