Dr. Mrinal Kumar Acharya
Neurology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I had a disk herniation from C2 to C3, which seems to have cleared up in the most recent image. I also have sporadic twitching of muscles all over my body, and the main problem now is the rotation of the head, and sometimes the head tilts left. My MRI reports suggest mild arthritic changes in the spine, mild bulging at C5 to C6, and mild indentation of the left ventral cord from a disk due to degeneration. Would this be limiting my neck's range of motion?
Kindly help.
Thank you.
Hello,
Welcome to icliniq.com.
I read your query and understand your concern.
Your MRI (magnetic resonance imaging) report suggests (attachments removed to protect the patient's identity) degenerative disk disease, and the disk bulging is mainly due to the degeneration, which is causing indentation of the ventral cord. Still, the most important thing to look for is to find if there are any signal changes in the spinal cord. In addition, you need a detailed neurological examination to look for the tone of the muscles as well as any signs of involvement of the pyramidal tract.
Treatment is mainly symptomatic. For treatment, I suggest the following.
(Consult your specialist doctor, talk with them, and take medications with their consent.)
1. Tablet Tolperisone (Tolperisone Hydrochloride) 150 mg thrice daily for five days.
2. Tablet Gabapentin 100 mg once daily before going to bed for five days.
3. Physiotherapy and neck muscle exercise for five days.
I suggest you repeat the electrophysiology tests like EMG (electromyogram) and nerve conduction study (NCS) again to evaluate the diffuse twitching, as it is not a common symptom of degenerative cervical spine disease, and you can follow up with the reports.
Thank you.
Investigations to be done
Treatment plan
Preventive measures
Regarding follow up
Patient's Query
Hello doctor,
Thank you for your response.
I had a neurological examination, and it was a normal response. No mention of increased or decreased muscle tone and muscle strength. Would you still want a repeat of EMG? The neurologist diagnosed me with benign fasciculations.
Thank you.
Hello,
Welcome back to icliniq.com.
If it Is benign fasciculation, there is no need to worry. Regarding your cervical MRI (magnetic resonance imaging), if there are no spinal cord signal changes, there is no need to worry. Therefore, you can continue the medicines I prescribed previously. Consult your specialist doctor, talk with them, and take medications with their consent.
Thank you.
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Neurology
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