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Thread: i am new here-recent MRI for wife shows area at c3 to c4 spinal cord

  1. #11
    Quote Originally Posted by wpm View Post
    No idea what demyelinating process is. The way it was explained to me is basically exposed nerves the sheathing is deteriorated.
    As a practical matter, that is accurate - a demyelinated nerve is often compared with an electrical wire with damaged or missing insulation. A "demyelinating process" refers to any condition that results in demyelination of nerves in the brain and/or spinal cord, including - but not limited to - MS.

    There are many, many neurological conditions that can cause demyelinating lesions (also known as "plaques"), and a variety of tests are performed in order to narrow the field. Diagnosis can be made quickly in some cases, but often it takes a long time and the diagnostic process can be quite frustrating. Your wife has a demyelinating lesion identified on MRI, but that finding is one piece of a puzzle that must include clinical examination, medical history and tests to rule out so-called "MS mimics."

    If you haven't already discovered it, the National MS Society has a very informative website. You might also like to read through some of the threads on the Tranverse Myelitis, Multiple Sclerosis, Non-Traumatic SCI forum here at CareCure. You might not find specific answers to your questions on the forum threads, but they will give you a sense of what people experience as they deal with these issues.

    It's very important that you find a neurologist in whom you have confidence; don't hesitate to get second opinions, and ask the doctor(s) a lot of questions based on your research, because while different neurological conditions tend to have characteristic presentations, each person's experience bears its own stamp.

  2. #12
    Quote Originally Posted by wpm View Post
    My wife has numbness to temperature on complete left side of her body except head and on the right side her arm has limited motion with weakness especially the further she extends her arm. She is 31 years old with no prior anything or family history she did fall about 5 feet the week before but had no soreness or bruising and was fine all week. Since the night this has came on we have been to the ER with xrays and cat scans that showed nothing so they recommended orthopedics which had MRI done of whole spinal cord it showed c3 and c4 brighter than the rest of spinal cord. The orthopedic said it could be a contusion or the outer sheathing damaged with the nerves exposed but said he doesn't know so he is sending us to an neurologist and it sounds like we may be doing a brain MRI next. I am not sure what i am expecting writing this just thought i would share and see what you'll thoughts we're. I can't sleep anyway to worried about the wife. I do work 2 full time jobs and have 2 kids one of them 1 year old so it may take me time in between writings thanks
    wpm,

    I am sorry that I did not see your post until just now. Based on your description alone, it does not sound like multiple sclerosis (MS). The MRI shows increased signal intensity around C3/C4. This suggets a contusion, transverse myelitis (TM), or stroke of the spinal cord. The fact your wife had a 5-foot fall the previous week may or may not have been the cause because, as you pointed out, she seemed to have been fine for a week afterward. If there were a hematoma pressing on the spinal cord, that would have been seen on the MRI.

    The neurological changes that you describe are consistent of a Brown-Secquard Syndrome. This term is used to refer to the neurological symptoms that are associated with a injury to one side of the spinal cord. Normally, the pain and temperature fibers cross over in the spinal cord shortly after they enter the cord and ascend on the other side of the cord. The motor tracts travel down the spinal cord on the same side. It sounds like she had a right sided injury that at C3/4 that is causing her arm weakness and loss of temperature sensation on the left side of her body.

    The fact that you are not describing weakness of her right leg suggests that she has not only a Brown-Secquard but also a central cord syndrome. This is a syndrome from the arms are paradoxically affected more than the legs. A central cord syndrome results from an injury to the lateral column of the spinal cord. I have described both of these syndromes elsewhere on this site. The fact that neurological symptoms are so localized suggests that your wife had an injury to the right spinal cord at C4.

    Her prognosis should be good. A vast majority of people who have central cord syndrome or Brown-Secquard syndrome recover both arms and legs. Some residual sensory dysfunction and motor weakness may remain for a year or more but I believe that she should eventually recover completely from this injury.

    So, what could have been the cause of her injury? A contusion is probably unlikely although a consequence (such as a hemorrhage or stroke) of the trauma may have caused the problem. If I were her doctor, I would probably try to rule out some other potential causes such as an arteriovenous malformation (AVM), look for inflammatory cells in the cerebrospinal fluid because TM is sometimes associated with inflammation, and ask about a history of a virus infection or vaccination because TM is often associate with having gotten a vaccine or infection. It is possible that she may never find out what the cause of the problem is.

    She will need rehabilitation, physical and occupational therapy. You should not worry. I think most of the bad stuff has been ruled out by the MRI. For example, she doesn't have a tumor. The injury is one from which she should recover almost completely although it will take time.

    Wise.

  3. #13
    Quote Originally Posted by Bonnette View Post
    As a practical matter, that is accurate - a demyelinated nerve is often compared with an electrical wire with damaged or missing insulation. A "demyelinating process" refers to any condition that results in demyelination of nerves in the brain and/or spinal cord, including - but not limited to - MS.

    There are many, many neurological conditions that can cause demyelinating lesions (also known as "plaques"), and a variety of tests are performed in order to narrow the field. Diagnosis can be made quickly in some cases, but often it takes a long time and the diagnostic process can be quite frustrating. Your wife has a demyelinating lesion identified on MRI, but that finding is one piece of a puzzle that must include clinical examination, medical history and tests to rule out so-called "MS mimics."

    If you haven't already discovered it, the National MS Society has a very informative website. You might also like to read through some of the threads on the Tranverse Myelitis, Multiple Sclerosis, Non-Traumatic SCI forum here at CareCure. You might not find specific answers to your questions on the forum threads, but they will give you a sense of what people experience as they deal with these issues.

    It's very important that you find a neurologist in whom you have confidence; don't hesitate to get second opinions, and ask the doctor(s) a lot of questions based on your research, because while different neurological conditions tend to have characteristic presentations, each person's experience bears its own stamp.

    Thank You

  4. #14
    Quote Originally Posted by Wise Young View Post
    wpm,

    I am sorry that I did not see your post until just now. Based on your description alone, it does not sound like multiple sclerosis (MS). The MRI shows increased signal intensity around C3/C4. This suggets a contusion, transverse myelitis (TM), or stroke of the spinal cord. The fact your wife had a 5-foot fall the previous week may or may not have been the cause because, as you pointed out, she seemed to have been fine for a week afterward. If there were a hematoma pressing on the spinal cord, that would have been seen on the MRI.

    The neurological changes that you describe are consistent of a Brown-Secquard Syndrome. This term is used to refer to the neurological symptoms that are associated with a injury to one side of the spinal cord. Normally, the pain and temperature fibers cross over in the spinal cord shortly after they enter the cord and ascend on the other side of the cord. The motor tracts travel down the spinal cord on the same side. It sounds like she had a right sided injury that at C3/4 that is causing her arm weakness and loss of temperature sensation on the left side of her body.

    The fact that you are not describing weakness of her right leg suggests that she has not only a Brown-Secquard but also a central cord syndrome. This is a syndrome from the arms are paradoxically affected more than the legs. A central cord syndrome results from an injury to the lateral column of the spinal cord. I have described both of these syndromes elsewhere on this site. The fact that neurological symptoms are so localized suggests that your wife had an injury to the right spinal cord at C4.

    Her prognosis should be good. A vast majority of people who have central cord syndrome or Brown-Secquard syndrome recover both arms and legs. Some residual sensory dysfunction and motor weakness may remain for a year or more but I believe that she should eventually recover completely from this injury.

    So, what could have been the cause of her injury? A contusion is probably unlikely although a consequence (such as a hemorrhage or stroke) of the trauma may have caused the problem. If I were her doctor, I would probably try to rule out some other potential causes such as an arteriovenous malformation (AVM), look for inflammatory cells in the cerebrospinal fluid because TM is sometimes associated with inflammation, and ask about a history of a virus infection or vaccination because TM is often associate with having gotten a vaccine or infection. It is possible that she may never find out what the cause of the problem is.

    She will need rehabilitation, physical and occupational therapy. You should not worry. I think most of the bad stuff has been ruled out by the MRI. For example, she doesn't have a tumor. The injury is one from which she should recover almost completely although it will take time.

    Wise.
    Thank You your comments made me and my wife feel better. We will keep everyone informed as we know more.

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