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C4/5 issues looking for answers please.

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Old 09-15-2009, 04:42 AM   #1
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C4/5 issues looking for answers please.

Recently I awoke in the middle of the night and my left hand on the left side, my pinky finger and the one next to it were completely numb and I could not move them - It was like they were paralysed. When I raised my arm and looked at my hand 2-4 seconds later the feeling in my hand returned to normal.

I went to see a Dr who referred me to a Orthopeadic Dr he ordered an MRI and the findings in a nutshell were...

1. Bony alignment and marrow signal are normal. C4/5 and C5/6 disc spaces are narrowed. Explanation:

2, Broad based disc protrusion is seen along posterior and left posterolateral margin of C4/5 disc. Left C4/5 neural foramen appears severely narrowed. Suggest correlation with symptoms and clinical findings. Central canal only shows mild narrowing. Right C4/5 neural foramen is mildly narrowed.

He put me on B vitamins and ordered some Physio. 4 or 5 sessions later and the physio has made no difference. I went to see him again and he referred me to a Neurologist and he gave me some anti-inflammatory's and some tablets called "Lyrica" and is a known nerve pain blocker and is usually very effective for these kinds of conditions.

The first night I took them it actually made the numbness worse when I awoke in the middle of the night instead of my left portion of my left hand feeling numb both hands felt numb! However the following night things were not as severe.

Now it seems things are getting progressively worse, there is a constant tingling (very slight) in my left hand and sometimes the right - My left arm also feels a bit strange. The muscles feel tense like I have been to the gym. Also when I lay down my left leg starts to tingle too, mainly the calve to foot area.

Is there anything I can take to stop this? This tingling feeling is driving me nuts! I now worry that soon I will be paralyzed in my hand and arm - Is this me just worrying or is this a possibility?

Any help and advice would be appreciated

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Old 09-15-2009, 09:19 AM   #2
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Re: C4/5 issues looking for answers please.

one thing about lyrica,which i have taken myself? it can create some really insane types of side effects, much more so for me than with any of the other types of meds in that same med group i have also tried. some can go away eventually, but this affected my eyes, legs, and my kidneys pretty severely so i had to go off of it. it is kind of up to you and how well this is working and or impacting you as to whether to just stay on it or try something more like neurontin? or one of the other anti siezure type meds that just can help with the more radiculopathic types of symptoms you are experiencing.

the one thing i see here in that rad report is really kind of odd to me. where it states that your symptoms actually correlate to the MRI findings you have only at c 4-5? the odd thing about this particular statement is that c 4-5 do NOT actually really go down far enough to actually even innervate the hand at all. once you hit the c 6 area, THEN you have actual hand/ finger innervation, but not before then, espescially with the type of full sensory loss you had at what is innervated more in the sensory at the actual c 7-8 level?

all you have to do here is just look up a few things and you will see what i mean. first, simply look up what are called the "dermatomes'? the dermatomes are nerve innervation distribution of the skin areas the nerves actually innervate. this will be a diagram of a "person" showing with lines just exactly what nerve innervates what area. then, looking up what makes up what is called the "brachial plexus" which is all what actually innervates from the arm down thru the fingers, and also REALLY look into the "peripheral nervous system". THAT is where you will see really well just how that arm down thru the fingers really are innervated. that c 4-5 just does not 'fit' with your actual symptoms, espescially at the last two fingers with sensory?

did you have ANY findings at all beyond the c 4-5 that went as far as the T 1? that T 1 also innervates the fingers too tho it is not part of the actual c spine. the one huge thing you also need to keep in mind here is that there is ALOT of real crossover or 'play' that goes on within all those last c spine nerves and that T 1 too. this just means that some of the nerves that innervate specific dermatoimes, also carry fine motor abilitys with innervation too, so you can feel or not feel certain things when it comes to the nerves that make up fine motor and the sensory in the hand and fingers. if i remember correctly, that c 5 does go down the arm but kind of stops short of the hand? but there are some 'support" muscles it does govern, but there is NO sensory innervation from that or below it and the c 4 only innervates around kind of the neck to very upper shoulder area?

see, this is what just does not sound 'right' about that report where it just correlates the level impacted with your last two finger symptoms(sensory in those fingers is usually the c 8/ulnar nerve). it just does not make real sense there. just look up what i mentioned above and you will see what i mean. but knowing if there just IS any hard findings beyond the c -4-5 would really be more likely or logical. i just do not quite get why the radiologist seemed to think this was correlated at all there. while it IS a pretty profound area of involvement you have at the level, something just does not sound 'right" there with it. while not everyones actual anatomy is always going to be "dead on target textbook", thats alot of difference between overall levels of how things are just innervated up there and in that hand/finger area, ya know what i mean? unless that c 6 is also involved, it would not involve that c 4 in any way shape or form to the fingers. maybe the rad could have missed that first level, since c 1 can sometimes be missed and not counted in some people or with an inexperienced radiologist too. just one thought. and then read the levels wrong?

if you have your MRI report in your posession, could you type out just what was actually found in that summary at the very end? it may help to clarify some things? but for your own knowledge, DO look up what i mentioned up above and get somewhat aquainted with this just so you can understand this a bit better yourself. trust me, it does help to know this stuff when you have something going on up there. marcia
3-22-01,herniated C-6-7
11-20-01,placement of hardware for failed fusion
9-22-03,removal of cavernous hemangioma that was inside spinal cord. Neuro damage to L hand L leg and R leg.

Old 09-15-2009, 08:56 PM   #3
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Re: C4/5 issues looking for answers please.

Thanks for your reply Maria,

The full report says...

Bony alignment is normal. Normal C1-2 articualtion is observed. Facet joints are normally aligned. Vertebral bodies are normal and intact. C4/5 and C5/6 disc spaces are narrowed. Marrow signal is normal. No focal bone lesion or marrow edema is noted.

At level of C4/5 disc, broad based disc protrusion is seen along the posterior and left posterolateral margin. Left C4/5 nueral foramen appears severely narrowed. Central canal is relatively less affected and only shows mild narrowing. The cors is normal in size and signal intenstity. Dural sac is indented but normal CSF signal anterior and posterior tot he cors is preserved. Right C4/5 nueral foramen is midly narrowed.

Medial end of right C5/6 nueral foramen is mildy narrowed. Small focus of hyperintense-T2 signal at central posterior margin of C5/6 disc suggests a small annular tear. Central Canal is normal Left C5/6 nueral foramen is normal in size.

Small central disc protrusion noted at C6/7 disc. Central canal is normal. Spinal cord is normal. Bilateral nueral foramina are patent.

No Abnormal prevertebral or paravertebral soft tissue mass is detected. Entire spinal cord is normal in size and intensity.

Bony alignment and marrow signal are normal C4/5 and C5/6 disc spaces are narrowed.
Broad based disc protrusion is seen alog posterior ad left posterolateral margin of C4/5 disc. Left C4/5 neural foramen appears severely narrowed. Suggest correlation with symptoms and clinical findings. Central canal only shows mild narrowing. right C4/5 neural foramen is midly narrowed.
Medial end of right C56 neural foramen is mildly narrowed. Small annular tear seen at posterior margin C5/6 disc.
Small central disc protrusion noted at C6/7 disc

Thank you for your referral (Radiology)

I am now worried do I have something more sinister like a very bad degenerative disease then?

What also concerns me is when I have had physio they have tried to recreate the numbness but failed to do so Maybe this is because its not neck related at all and brain related?

I had a brain MRI with and without contrast in April and it was all clear.

Last edited by Axa; 09-15-2009 at 09:03 PM.

Old 09-21-2009, 12:45 PM   #4
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Re: C4/5 issues looking for answers please.

Hi - how are you feeling since these symptoms appeared? I was reading your post and since I had s ome similiar symptoms I was curous whether any rest helped the symptoms. I have a C5/C6 herniation with forminal stenosis and it resulted in tingling/numbness down my left arm and thumb. Really drove me nuts because the sensation was so odd and uncomfortable. Since them I was on a week of steroids, then a lot of rest and later PT. My condition has improved (knock on wood) and I'm returning to work on Monday after being out on disability for 2 months. My doctor said that most of these conditions do not result in surgery and conservative treatment will be enough for most. I hope he's right - but a lot of it depends upon the individual condition.

The other question I have is regarding the supplements. Since this happened I looked on line for vitamins/minerals that might help and started taking the following: B6, B12, Folic acid, flaxseed, fish oil, Vitamin D, calcium and somethin called MSN. The doctor didn't recommend it, I researched on line and came across it. Is there anything else your taking?

Please keep us posted on how you're doing. I hope thing turn around for you.

Old 09-21-2009, 06:34 PM   #5
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Re: C4/5 issues looking for answers please.

I'm no expert, but I would doubt that numbness this specific would be from your brain, especially if you already had a clear brain MRI. One thing to consider is that if a nerve in your elbow is compressed, those two fingers can experience numbness. I believe it is your ulnar nerve that runs to those two fingers. If it is gone and it has not come back, it may be that it was just caused by sleeping in a funny position. I have had those two fingers go numb quite a bit at night and it always goes away.

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