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Member
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Join Date: Jan 2009
Location: Paradise
Posts: 855
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Member
Join Date: Jan 2009
Location: Paradise
Posts: 855
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Quote:
Originally Posted by wllwrt4fd
Indication: Numbness of legs
Technique: MRI lumbar spine with sagittal and axial T1 and T2
weighted images, postcontrast sagittal and axial T1-weighted images.
Contrast: 11 mL Multihance IV.
Findings: Alignment is near-anatomic. Vertebral body and disk
heights relatively preserved. No suspicious focal T1 dark marrow
lesions. Small Schmorl's nodes are noted at some levels for example
superior endplate L3. No significant compromise of the canal or
neural foramina at any level. Distal cord and conus is within normal
limits position T12/L1 and roots of cauda equina appear within normal
limits.
Probable nerve root sheath cyst noted along the extraforaminal S1
nerve root and to a lesser extent S2 nerve roots more proximal, not
uncommonly seen.
No abnormal enhancement cord, cauda equina, or coverings.
Impression: Unremarkable MRI lumbar spine except for probable nerve
root sheath cysts associated with right S1 greater than S2 nerve
roots, not uncommonly seen. No explanation for bilateral lower
extremity numbness.
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These are not huge findings but does underscore the necessity to correlate your physical exam findings with your imaging findings or lack thereof.
I assume that all has been exhausted looking for metabolic causes? At this point, if all has been explored, it may be time to go fishing for the outlires. From what I am reading, your issues are more sensory than they are inclusive of motor involvement so less common neurodiagnostic tests like DSSEP's (derma somatasensonsory evoked potentials) do tests the sensory portion of the nervous system and may be worthy of persuing should your profile warrent it. It is possible that your symptoms could be coming from higher up and probably should now be considered but I wouldn't put a lot of stock in that direction...
Good luck!
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