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What Does This X-ray Report Indicate?

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Posted on Fri, 8 Jul 2016
Question: Hi,

From last few months i have been having these symptoms -
1. In between tremors in my hands and fingers ( noticed twice or thrice a week)
2. Loss in balance while walking
3. Confusion & memory loss in between ( difficult to recollect names at times)
4. Sleep trouble.

I have a sever neck pain and when i did the X ray , It showed degenerative Spondlysis in C5 and C6 section. This was done almost 4 months back.

Kindly suggest based on my condition.
doctor
Answered by Dr. Ishu Bishnoi (1 hour later)
Brief Answer:
Consultation

Detailed Answer:
Hi XXXXXXX thanks for asking from HCM.


I can understand your concern. You have symptoms of cerebellar and cerebral disease.

The tremors and loss in balance could be due to
: Cerebellar damage - If you had tremors on one side and fall on same side, it is more likely to be due to that cerebellar lobe e.g. trauma, tumor, cyst, dysplasia etc. If both sides, it could be systematic damage of cerebellum like alcohol, vitamin B12 deficiency, spinocerebellar ataxia.

: Spinal cord damage like posterior cord - Posterior part or back side of spinal cord damage can cause balance difficulty/tremors/loss of position sense, more pronounced symptoms in dark. It can be either one side or both sides.

If you are using any medication, kindly let me know. Drug abuse with antidepressants can be a factor. I will tell you the side effects and relation between your symptoms and drug.

Now coming to other symptoms like the confusion, memory loss and sleep trouble could be due to various other causes also like Depression, anxiety and especially chronic sleeplessness.

So to discusss the pin point the cause you must discuss it with neurologist. He will examine your nervous system, higher mental function and advise investigation like

: MRI of brain with or without spinal cord
: Blood level of sugar, B12, haemoglobin, protein
: If doubt of infarcts, ultrasound doppler or/and CT angiography of brain and neck vessels.
Usually these investigations are sufficient to make any conclusion. Rarely, uncommon disease may need specific investigations.

Regarding cervical spondylosis (C5-C6), it is common to have some degenerative changes at 34 years age. You should not worry about it. Kindly follow few tips to strengthen your spine

: Avoid prolonged neck bending. Avoid prolonged use of laptop/mobile
: Do neck muscle strengthening exercise. You can consult physiotherapist for it.
: Avoid thick or more than one pillow use.
: Keep your bones strong by getting adequate sunlight exposure (>5min/day), eating calcium/vitamin D rich food like dairy products/eggs
: In case of neck pain, do neck massage and use soft neck collar while travelling/working.
: Try to avoid painkillers as much as possible.

Hope it will help. If still in doubt, do let me know, I would be happy to help you.

Thanks. Take care.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ishu Bishnoi (1 hour later)
Hi, Thanks for the information.

Just to give you a brief - I am not on any anti depressant medications, except for Rosuvastatin tablets to reduce cholestrol.

In April 2015, I was admitted in fortis hospital due to loss of sensation in my arms/ legs and slight loss of balance, then i had consulted a neurologist. he had suggested a CT Scan of the brain and everything was normal then.

I have been having these issues worsening from past 3 - 4 months.

Spondilytis does give me neck pain and swelling around the neck, but tremors and loss of balance increased recently.

I have anxiety attacks in between, but not off late.

Regards,

XXXX

doctor
Answered by Dr. Ishu Bishnoi (1 hour later)
Brief Answer:
Consultation

Detailed Answer:
Hi XXXXXXX welcome back.

Your information is quite helpful in reaching unto some conclusion. It is good that there is no medication or drug abuse. using Rosuvastatin can cause few side effects like

: unexplained muscle pain, tenderness, or weakness
: confusion, memory problems
: fever, unusual tiredness, and dark coloured urine
: swelling, weight gain, urinating less than usual or not at all
: drowsiness, dry skin, blurred vision, weight loss
: nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colorer stools, jaundice (yellowing of the skin or eyes).
: headache, depressed mood
: mild muscle pain, joint pain
: sleep problems (insomnia)
: constipation.

SO in my opinion rosuvastatin can cause almost all effects which you are experiencing presently. You should consult your physician about these effects and ask about change of drug or reduction in dose.
But if you have started using it after developing those side effects, then you must rule out other enlisted causes mentioned in previous answer.
You must focus upon
: Vitamin B12 level
: Blood sugar level
: MRI of spine to know about posterior spinal cord status.
: Thyroid profile

Do let me know about these reports. I will be happy to help you .

Thanks. Take care.
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
Answered by
Dr.
Dr. Ishu Bishnoi

Neurologist, Surgical

Practicing since :2007

Answered : 901 Questions

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What Does This X-ray Report Indicate?

Brief Answer: Consultation Detailed Answer: Hi XXXXXXX thanks for asking from HCM. I can understand your concern. You have symptoms of cerebellar and cerebral disease. The tremors and loss in balance could be due to : Cerebellar damage - If you had tremors on one side and fall on same side, it is more likely to be due to that cerebellar lobe e.g. trauma, tumor, cyst, dysplasia etc. If both sides, it could be systematic damage of cerebellum like alcohol, vitamin B12 deficiency, spinocerebellar ataxia. : Spinal cord damage like posterior cord - Posterior part or back side of spinal cord damage can cause balance difficulty/tremors/loss of position sense, more pronounced symptoms in dark. It can be either one side or both sides. If you are using any medication, kindly let me know. Drug abuse with antidepressants can be a factor. I will tell you the side effects and relation between your symptoms and drug. Now coming to other symptoms like the confusion, memory loss and sleep trouble could be due to various other causes also like Depression, anxiety and especially chronic sleeplessness. So to discusss the pin point the cause you must discuss it with neurologist. He will examine your nervous system, higher mental function and advise investigation like : MRI of brain with or without spinal cord : Blood level of sugar, B12, haemoglobin, protein : If doubt of infarcts, ultrasound doppler or/and CT angiography of brain and neck vessels. Usually these investigations are sufficient to make any conclusion. Rarely, uncommon disease may need specific investigations. Regarding cervical spondylosis (C5-C6), it is common to have some degenerative changes at 34 years age. You should not worry about it. Kindly follow few tips to strengthen your spine : Avoid prolonged neck bending. Avoid prolonged use of laptop/mobile : Do neck muscle strengthening exercise. You can consult physiotherapist for it. : Avoid thick or more than one pillow use. : Keep your bones strong by getting adequate sunlight exposure (>5min/day), eating calcium/vitamin D rich food like dairy products/eggs : In case of neck pain, do neck massage and use soft neck collar while travelling/working. : Try to avoid painkillers as much as possible. Hope it will help. If still in doubt, do let me know, I would be happy to help you. Thanks. Take care.