On 12/14 I went to the ER for decreased sensation
When I originally went to the ER on 12/14 they got an MRI of my spine which showed cervical myelopathy and cervical stenosis and some protruding discs in my lumbar area. I am a nurse so that was not at all a shock to me. I do not have any neck pain or back pain, just little normal aches when getting up and so forth but nothing terrible and nothing I ever discussed with my PCP because it is so insignificant. When I asked the ER MD why he got a MRI of my spine he said the neurologist on call was looking for lesions in the spine. There were none. I went to a neurologist at Massachusetts General Hospital who did an office exam and referred me to a neurologist because he said it was probably the cervical myelopathy. I am seeing him next week. I guess my reflexes and office exam was ok. I am worried because everyday the tingling in my entire lower body is more and more. Should I see another neurologist and does it sound like a neck and back problem or a neurological disease? My mind has not been as sharp either for the past few months. I am always on top of everything and now things slip by me and I am a more forgetful, ie. if I am driving I may take a wrong turn on a road I drive every day. I was having trouble holding my bladder but that actually seems better. I have not had a brain MRI
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Hi and Welcome to "Ask a Doctor" service.
I have read your question and here is my advice.
I am Sorry to hear of your problem and understand your concerns.
The pain and uncomfortable feeling, the burning in lower body can be well explained by the spine problems. The spinal stenosis and prolapsed disc can press on the spine hence causing pain and discomfort below. This is typical for pain of spinal stenosis to increase with coughing or STRAINING. So it looks to be the spine and is very unlikely to be related to any brain problem or nuerodegenerative disease. The problem can be addressed by proper physiotherapy and certain drugs. Your neurologist would help you here after a detailed examination of your legs.
Regarding the other issues like tingling in ears and forgetfulness, they may not be related and need assessments. Causes are a lot, to mention few, these include anemia, thyroid disease, stress and anxiety, vit deficiency, infection, and rarely brain disorders. So you should discuss this with your nuerologist as well for assessment . We generally advise a panel of tests for above mentioned problems to be sure all is fine.
Hope I have answered your question. Please feel free to ask If you have any other question or concerns.
Kind Regards Dr Mahboob Ur Rahman
Very unlikely to be MS,
Hi and thanks you for writing back to us. Both of the points you raised are very valid and let me explain each.
1. Very right, that cervical mylopathy or spinal Stenosis can cause severe pain. However this is not always a rule. Different pathways (like that of pain, or vib) run in the spine and it depends which area is compressed that would produce the corresponding symptoms. So. If the pain pathways fibers are not compressed, it may be painless. However the examination is necessary, we need to rule out perephral neuropathy (lesion of perephral nerves) which can also produce tingling. We need a nerve conductin test for it. But that depends on examination findings. But spinal problems may not produce pain.
2: Similarly you second point that these symptoms may be MS is quite reasonable. However there are few reasons I don't think it would be MS.
A. MS is relapsing, remitting most of the times, and typically produces weakness rather then numbness or pressure. The examination finding is very important here as MS is an upper motor nueron disease ( a term we use if brain or first order nerves coming from Brains are involved) and have a special examination findings ). These include like increased tone and increased reflexes and weakness. I appreciate it would be difficult for you to understand this but you examiner would easily recognize it.EVen if this was a lesion of MS in the spine, the MRI would have picked it. Still I repeat its the examination of the lower limb that easily pick changes that would suggest MS.But these symptoms clealry suggest spinal Stenosis or disc problem rather then MS.
Hope it clear your mind, please don't hesitate to ask if you still have any questions. I will be glad to answer any further queries.
It's a pleasure for me.