Dr. Aida Abaz Quka
Neurology
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Patient's Query
Hello doctor,
I got hit on the left side on cervical region almost two years from now. magnetic resonance imaging (MRI) does not show any injury or significant stenosis but the electromyography shows left moderate radiculopathy C5-C8 and recent results showed deterioration. Symptoms also still exist on left arm and trapezius but recently for the first time, I started feeling some irritations in the left leg too. My questions are the following: How this will progress you think? MRI shows nothing significant anatomically but radiculopathy deteriorates and emg results. Is this possible you think to start having the same problems in the leg too? This will constitute kind of myelopathy. Is it?
Hello,
Welcome to icliniq.com. Regarding your concern, I would explain that as there are no signs of myelopathy or spinal canal compression on magnetic resonance imaging imaging (MRI), there is no reason to panic about myelopathy. The pain in this region is related to the nerve damage. Physiotherapy can help improve your situation. I would also recommend trying a cervical collar during pain exacerbation. I do not think that it will progress. It is also important avoiding heavy weight lifting and use an orthopedic pillow. Regarding the irritation on the leg, I would recommend performing a lumbar spine X-ray study in order to investigate for possible chronic degeneration or the lumbar vertebral column, which may mimic this clinical situation.
Patient's Query
Thank you doctor,
Because nerve damage is not observable in Magnetic resonance imaging (MRI), neither in computed tomography (CT) scan or X-ray or ultrasound and electromyography (EMG) is not an anatomical examination, is there any other examination I can do to observe anatomically this nerve damage at C5-C8?
Hello,
Welcome back to icliniq.com. Unfortunately, there is no other test besides magnetic resonance imaging (MRI) and ENG. Electroneurography (ENG) is a good test to examine the function of the nerves, while the MRI examines if there is any signs of compression in the spinal cord or intervertebral discs (any discal herniation or bulging), which can lead to compression of the nerves and damage. Anyways, as the ENG is abnormal, I would recommend repeating it with another doctor (radiculopathy is related to compression of the nerve roots at the levels when they leave the spinal cord). If there are no signs of compression in the spinal cord MRI, then we have to put into discussion the ENG results. Another possible cause ofnerve damage C5-C8 is local inflammation, which is not related to discal bulging. For this reason, I recommend performing a brachial plexus MRI with gadolinium enhancement, coupled with inflammation tests (complete blood count, PCR, ERS for inflammation). In such a case, steroids can help improve the situation. I would also recommend Vitamin B complex supplements and a lot of physiotherapies. You should discuss with your doctor on the above issues.
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Neurology
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