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  • New Symptoms... drooping eyelid, decreased nasolabial fold

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    Old 05-31-2012, 12:38 PM   #1
    Sunnyblu
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    New Symptoms... drooping eyelid, decreased nasolabial fold

    Well I went last Friday to get my last cervical epidural injection and the pain medicine doc decided not to give it to me. I was letting her know about the new headaches I have been getting along with the fullness sensation in my ears and head upon standing. She examined my neck and left shoulder and said that I had one of the worse muscle spasms she has seen over the left trapezius muscle. She then performed a neurological exam and had another doc come in and they both concurred that my left eyelid was drooping mildly and that the nasolabial fold on the left side of my face was decreased. I also have Chiari Malformation which was found during a past MRI of the cervical spine. All of my pain is on the left side, the left should and forearm aches all day. I occasionally have tingling in my first 3 fingers. Putting my chin to my chest causes pain in the shoulder, under my left arm and back shoulder blade. I have had random periods of vertigo, waking up with blurry vision in one eye and dim vision in one eye if I wake up in the middle of the night to go to the bathroom. However those symtoms come and go and I never know when they are going to show up.

    The doc now wants me to have a full neurological workup. My appointment is tomorrow but I am just really nervous and wondering what could be the problem. The pain docs office notes mention that she doesn't feel that the new symptomology corresponds to my last MRI which showed ddd of the neck, two bulging discs, facet arthropathy and hypertrophy among other things.

    Any ideas what the new symptoms might suggest?

     
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    Old 05-31-2012, 01:25 PM   #2
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    Re: New Symptoms... drooping eyelid, decreased nasolabial fold

    The shoulder/arm/hand symptoms sound like pretty straightforward cervical spinal problems, down in the C4-C7 area. I can't say anything about the facial symptoms.

    See if you can get your MRI radiologist's report and post it here, which will certainly help...

     
    Old 05-31-2012, 02:08 PM   #3
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    Re: New Symptoms... drooping eyelid, decreased nasolabial fold

    Hi Sunny.

    Your facial symptoms and eyelid drooping aren't neck symptoms. Could be a small stroke, Bell's Palsy developing or even MS....and many others.

    One of the things that always bothers me is when docs attribute everything to a known problem and therefore miss a new symptom of something else. Your doc's did good in deciding this needed major attention and that it wasn't spinal.

    Chances are, it's something transient that will go away with time but it's important to know what it is. Please let us know what they find tomorrow.

    gentle hugs............Jenny

     
    Old 05-31-2012, 02:12 PM   #4
    Sunnyblu
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    Re: New Symptoms... drooping eyelid, decreased nasolabial fold

    Here is what the most recent MRI Report said which was compared to a previous study done almost 1 year earlier:

    Apparent vertebral body hemangioma is again noted in the T2 vertebral body. Note is again made of low lying cerebellar tonsils.

    C2-C3 no central or foraminal stenosis

    C3-C4 Unconvertebral joint hypertrophy and facet arthropathy causing mild right neural foraminal narrowing without central canal stenosis

    C4-C5 Mild unconvertebral joint hypertrophy and facet arthropathy.

    C5-C6 Disc osteophyte along with paracentral disc protrusion. Unconvertebral joint hypertrophy and facet arthropathy causing moderate bilateral neural foraminal narrowing and effacement of the thecal sac without central canal stenosis.

    C6-C7 Disc osteophyte along with right paracentral disc protrusion effacing the thecal sac and abutting the spinal cord without cord compression. Moderate unconvertebral joint hypertrophy and facet arthropathy is again present at this level causing moderate left neural foraminal narrowing.

    C7-T1 unremarkable

    Impression:
    1. MRI of the cervical spine with disc osteophytes at c5-c6 and c6-c7, as well as paracentral disc protrusion at C5-C6 and C6-C7. Multi level foraminal narrowing.

    2. Note is again made of of low lying cerebellar tonsils 11 mm into the foramen magnum suggesting Chiari Malformation. Straightening and reversal of the normal cervical lordosis is seen.

    3. There is appearance of an empty sella.

     
    Old 05-31-2012, 02:17 PM   #5
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    Re: New Symptoms... drooping eyelid, decreased nasolabial fold

    Maybe I misunderstood... will a "full neurological workup" not include a cervical MRI? The part about putting your head down and that causing shoulder/arm problems sounds very much like cervical spinal in nature. I have had something similar.

    I'd put a twist on what Jenny said, and that's that docs seem to be biased in finding one explanation for symptoms that may very well have more than one cause. I've been a victim of that, myself....

     
    Old 05-31-2012, 02:23 PM   #6
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    Re: New Symptoms... drooping eyelid, decreased nasolabial fold

    OK... now I see the MRI. Doesn't seem too bad, although when one radiologist says "moderate" (as yours does, regarding foraminal narrowing), another might say "severe". I still think it's entirely possible that your left shoulder/arm/hand problems come from your C6 and C7 foramina.

    The face is another issue, unfortunately....

     
    Old 05-31-2012, 02:35 PM   #7
    Sunnyblu
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    Re: New Symptoms... drooping eyelid, decreased nasolabial fold

    Thanks Jenny and Webdozer! The MRI results I posted are from march as ordered by my Primary Care doc to follow up on continuing pain issues I am having. I haven't seen the neurologist yet, I see her tomorrow. Pain clinic doc wants her to order another MRI and CAT scan. I will likely have more test results soon. When I first began having neck issues it was my Rheumatologist who ordered my first MRI last year. When she saw the Chiari she sent me to a neurosurgeon who determined there was no surgery needed at the time. Evidently I should be having ongoing checks with a neurologist for the Chiari, which no doc suggested I do. I will post after I see the neurologist tomorrow. Thanks again!

     
    Old 05-31-2012, 04:02 PM   #8
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    Re: New Symptoms... drooping eyelid, decreased nasolabial fold

    Sunnyblu...

    When I had my neurological workup (to rule out MS and/or strokes) they did a brain MRI to look for lesions, and a ct scan of my head to look for blockages and/or aneurysms. Let us know if your MRI and ct scan are of your brain, spine or what.

    It's nice you don't have to wait long for your appointment.

    Good luck, Kenzi!

     
    Old 05-31-2012, 06:18 PM   #9
    Sunnyblu
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    Re: New Symptoms... drooping eyelid, decreased nasolabial fold

    Thanks Kenzi! I got in so quickly because the pain doc called to request an appt asap. I will update with what the neuro doc says and after taking any tests she orders.

     
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