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Getting Stabbing Pain On Base Of Neck And Near Shoulder Blade. Could It Be A TIA Or Pinched Nerves?

Posted on Fri, 23 Nov 2012

Question: Stabbing pain on base of neck and near shoulder blade (all on the left side) and it seems all my symptoms start when the pain begins, but it causes me numbness in half my face, dizziness and some confusion with shock like feeling in fingers and left eye gets blurry and gets sticky. I never had any drooping of the face (my smile is normal) and I can always keep both arm raised without them dropping( had an MRI done in XXXXXXX brain and neck nothing abnormal but I have a bad disc in my lumbar region), I am a smoker I do exercise lipid panel is good HDL a bit low LDL 85 TC 163 also No HTN or DM or CVD, I exercise and lost 32 pounds since XXXXXXX by exercise and dieting. My concern could it be a TIA or pinched nerves? this problem has been chronic over a year and 4 months and driving my crazy
Also I am a student that spends a lot of time on my laptop

Answered by Dr. Sudhir Kumar (1 hour later)

Hi,

Thank you for posting your query.

There are two possibilities for your symptoms:

1. TIA (transient ischemic attack)- in this condition, the blood supply to a part of brain gets reduced for a while resulting in neurological symptoms, which subside within 24 hours, mostly within an hour.

Smoking and low HDL could be the risk factors for the same.

You should also check serum homocysteine, which could also be a risk factor for the same.

2. Partial seizures- if your symptoms are episodic, lasting for a few seconds to minutes, then this could be a possibility.

Regarding pinched nerves, your symptoms suggest a possibility of the same in the cervical region (neck), but your MRI of neck is normal, so, that has been excluded.

I hope it clarifies. Please get back if you have any further queries.

Best wishes,
Dr Sudhir Kumar MD (Internal Medicine) DM (Neurology) XXXXXXX consultant Neurologist
Apollo Hospitals, Hyderabad

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sudhir Kumar (9 minutes later)

I dont understand how it could be a TIA or a Partial seizure? the MRI (brain and neck no contrast) I took it in XXXXXXX showed no abnormalities. my symptoms are there all day everyday and I notice my neck and shoulder muscles spasm. I dont have hypertension. I do have anxiety and stressed all day due to school could this be it?

Answered by Dr. Sudhir Kumar (18 minutes later)

Hi,

Thank you for getting back with more details.

I agree with you that TIA or partial seizure are not likely, if you have these symptoms 24 hours a day and every day (that is, there is no time when you are normal).

However, if you have normal periods (without any symptoms), TIA should be excluded.

MRI of brain is often normal in TIA, and it is diagnosed on the basis of clinical presentation. MR angiography of brain and neck blood vessels may help in diagnosis, as that can show any narrowing of the arteries.

As I said, pinched nerves in the neck is the most likely diagnosis on the basis of your symptoms, and you may repeat MRI cervical spine, if required, for a diagnosis.

Starting physiotherapy (IFT/ultrasound, etc) and neck extension exercises would be useful. Also, drugs such as pregabalin would also be useful.

Anxiety and stress can aggravate your current symptoms.

I would be pleased to answer, should you have any more queries.

Best wishes,
Dr Sudhir Kumar MD (Medicine) DM (Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sudhir Kumar (15 minutes later)

let me just add the confusion was more like lightheadedness (foggy feeling)also I get a stabbing pain in my ear when I get a bit lightheaded. Also when I feel my muscles in neck, shoulder and back tense up I get a pain that runs from my left shoulder down my triceps to below the elbow and finally down to my pinky and ringer fingers. I never fainted or loss my awareness at anytime. When I wake up in the morning I feel fine but when I remember I have those symptoms they come back. Also if it helps the MRI was order by my neurologist at the time ( they told me I was fine). I am on my laptop over 8 hours a day.
My last questions is could tension in the neck, shoulder or back (all on left side) cause symptoms like half my face feel numb burning and feels like pins or needles? could muscle be pressing against my trigeminal nerve on the left side?

Answered by Dr. Sudhir Kumar (21 minutes later)

Hi,

Thank you for sharing more details.

Trigeminal neuralgia (TN) or the compression of Trigeminal beve can not occur due to problems in the neck.

TN is due to compression of the nerve inside the brain. Trigeminal nerve arises from brainstem, and the commonest reason for this nerve compression is a blood vessel abutting on the nerve. This can be diagnosed with MR angiogram of the brain.

All your other symptoms (except for numbness, burning and paresthesias over face) can be explained by nerve compression or pinching in the neck.

Best wishes,
Dr Sudhir Kumar MD (Medicine) DM (Neurology) XXXXXXX consultant Neurologist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar