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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Does persistent weakness in the arm require medical attention as per the attached CT scan?

Answered by
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Dr. Ishu Bishnoi

Neurologist, Surgical

Practicing since :2007

Answered : 830 Questions

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Posted on Sat, 6 Oct 2018 in Headache and Migraines
Question: This is a follow up question for Dr XXXXXXX Bishnoi

I have a CT scan report for him on a case he was looking at.
doctor
Answered by Dr. Ishu Bishnoi 14 hours later
Brief Answer:

CT report interpretation

Detailed Answer:

Hi,


Welcome back. Sorry for replying late. I was busy at my hospital.
After reading the new CT cervical spine report, I can analyse that

- Her cervical spine decompression is good. There is no spinal canal or neural foramina narrowing.

- Her bony alignement is okay except minimal listhesis at C4-5 level. Usually this much listhesis does not cause any symptoms.

- Only worrisome thing is loss of cervical lordosis. It is suggesting that her neck muscles are in spasm. It can be due to pain and/or poor physiotherapy.

Based on CT report, my suggestion is

- Ask her to do good neck exercise and stretching

- Avoid lifting any kind of weight

- Hot fomentation thrice a day

- Apply diclofenac gel to relieve pain

- If still spasm and pain persists, she can take tablet diclofenac with chlorzoxazone after prescription.

It will help her. Please also tell me hows she? Is she improved or same?

Hope I have answered your query. Let me know if I can assist you further.
Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Ishu Bishnoi 3 hours later
Thank you Dr. XXXXXXX

Thanks too for asking how she is. Overall she is mostly the same and, having persevered this for 3 years, she says she is learning to live with the pain. Our biggest concern is she might actually be getting worse because there is gradual weakness in her arms. She now has to hold a cup of coffee with both hands to manage. That's disconcerting. But was shall follow your instructions above and report later on progress.

Best regards.

Otswila.
doctor
Answered by Dr. Ishu Bishnoi 14 hours later
Brief Answer:

Thank you for appreciation

Detailed Answer:

Hi,

As her CT cervical spine is almost normal, the weakness should not increase because of compression or narrowing. For her weakness, please

- Get her power assessment done from a physiotherapist or doctor. Compare it with her old records. It will give an idea of damage and its degree.

- If there is significant decrease, nerve conduction studies and electromyography of concerned nerve and muscle can identify the damage and its type.

After this, the treatment of weakness can be given. Till then, continue the previously mentioned treatment.

I really hope she recovers.

Hope I have answered your query.

Take care

Regards,
Dr. Ishu Bishnoi, Neurologist, Surgica
Above answer was peer-reviewed by : Dr. Kampana
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