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Old 10-24-2015, 09:58 PM #1
itburns itburns is offline
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Default Would Like Some Advice Dealing w/my PN

Hello,

In 2003 I had corrective surgery for scheuermann's kyphosis. My entire thoracic spine was fused.

About the beginning of this year I started experiencing loss of motor control in my right hand, along with tingling. I had an MRI of my cervical spine and it showed stenosis. In January of this year I decided to get a laminoplasty of my cervical spine.

The surgery resolved the issues in my right arm. I started to experience paresthesia in my abdomen, the sides of my groin, thighs, and tops of my feet. On my followup with my surgeon he told me my PN could not be a result of my laminoplasty.

I got an appointment with a neuro who prescribed me 50mg/3x a day and an MRI of my lumbar to see if that was causing my PN. Unfortunately all the metal from my kyphosis surgery obscured the results but I can post what they found below:

MRI SPINE LUMBAR WITHOUT CONTRAST: 9/4/2015 5:00 PM
HISTORY: PARESTHESIA, history of Scheuermann's kyphosis and corrective surgery at age 18 affecting his thoracic spine, paresthesias down his legs
COMPARISON: Lumbar spine MRI 01/11/2012
TECHNIQUE: Appropriate pulse sequences were employed in multiple planes.
FINDINGS:
This study assumes five lumbar type vertebra.
Alignment: Alignment is within normal limits.
Marrow: Significant susceptibility artifact emanates from spinal fusion hardware in the visualized thoracic spine extending to L2. Evaluation of these levels is essentially nondiagnostic.
Conus: Obscured by susceptibility artifact.
T12-L1 and L1-L2: These levels are obscured by susceptibility artifact and evaluation is nondiagnostic.
L2-L3: Partially obscured by susceptibility artifact. Sagittal images demonstrate no evidence of spinal canal or neural foraminal stenosis.
L3-L4: Trace disc bulge without spinal canal or neural foraminal stenosis. Mild bilateral facet degeneration.
L4-L5: Disc degeneration with mild loss of disc height. An annular disc bulge has a superimposed right paracentral protrusion/fissure. The disc material indents the ventral thecal sac without causing significant spinal canal stenosis. Mild bilateral foraminal encroachment is stable. Minimal facet degeneration.
L5-S1: Disc degeneration with mild loss of disc height. The previously seen left paracentral disc protrusion has resolved. A small annular disc bulge flattens the ventral thecal sac without causing spinal canal stenosis. Mild bilateral facet hypertrophy with slight right neural foraminal encroachment.
Sacrum: Normal appearance of the visualized portions of the sacrum, without evidence of acute fracture or suspicious lesion.
Soft tissues: The paraspinous soft tissues and visualized portions of the retroperitoneum are unremarkable.
IMPRESSION:
1. Interval resolution of the previously seen L5-S1 disc protrusion.
2. Mild degenerative disc disease L4-L5 and L5-S1 without spinal canal stenosis or nerve root impingement, otherwise unchanged.

The neuro told me there was no impingement and I assume the cause of my PN is unknown. I think something happened during my last surgery.

I'm wondering if now I have to deal with PN for the rest of my life and if it will only get worse.. I've been suffering from depression this whole year and was hospitalized for suicidal behavior. I'm currently getting Electro Shock Therapy and wondering if that affects my PN.

I have a followup with my neuro next week, as well as my surgeon. Is there anything I should be asking them?

Should I be taking supplements? Avoiding things like alcohol? Any advice you think would be helpful I would be happy to hear. Sorry this was so long.
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Old 10-25-2015, 11:30 AM #2
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Hello itburns,

Sorry you find yourself here, but welcome.

Like a lot of us, you appear to falling into the idiopathic PN black hole. There is a cause, of course, but it's escaping current medical diagnostic capabilities...or the right tests just haven't been ordered.

I have a lot of spinal issues as well, but nothing that explains the neuropathy. Still, could something be going on that they just don't understand yet? I certainly think so. Or it also could be something completely unrelated that is also escaping detection by all the tests I've had done.

I guess the only input I have is to not let your spinal issues obscure the possibility that your PN is being caused by something else. Here's a list from Mayo:

http://www.mayoclinic.org/diseases-c...s/con-20019948

Blood sugar issues and B12 are biggies. If you have unknown problem with the former, dietary changes could help. And yes, reduction of alcohol consumption could help as well.

Supplements could possibly bring you some relief, but it's a bit like throwing darts. MrsD has a nice thread discussing various ones you can try.

http://neurotalk.psychcentral.com/thread121683.html

I wouldn't expect a neuro to be terribly encouraging of taking supplements. At least that was my experience. My integrative medicine doc encouraged lipoic acid, though. All the others ones I'm taking I learned about on my own, and many from this forum.

If it offers encouragement, my idiopathic small fiber neuropathy has not worsened in two years. My symptoms seem to morph and change on a whim, but I don't think they're worse.

As far as your appointment goes, make sure your neuro has ruled out all the other possible causes. And don't let him gloss over the blood sugar ones. It seems doctors aren't raising red flags when some people are pre-diabetic. You don't have to be a diagnosed diabetic to have neuropathy caused by blood sugar.

Last edited by janieg; 10-25-2015 at 11:54 AM.
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Old 10-25-2015, 11:40 AM #3
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Lightbulb

So you do have metallic hardware in your spine?

There are some people who are intolerant of devices and metals
in various replacements for joints and fusions.

If this is the case for you, there is not much you can do about it
I am afraid.

Do examine your lifestyle for toxins, heavy metals, glucose metabolism, various drugs, and vaccines. Some food intolerances can cause burning. The Nightshade veggies are one group of foods that can cause burning. MSG in processed and restaurant foods is another.
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Old 10-25-2015, 03:35 PM #4
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@janieg Thanks for the welcome. Yes, I do feel I'm never going to get answers and if I do know the cause... If the nerves have been damaged I do not know if they can be healed. I feel like I've lost my way of life at 30 years old. I think my PN is caused by my last surgery because coincidentally it showed up after my laminoplasty.

I will get my blood tested. See if I have below 400 b12. I will look into mrsD's recommendations for supplements. My last neuro told me to stop taking a multivitamin because I had high levels of b6.

@mrsD Yes I've had metal in my spine since 2003. I am confused though as I didn't start to develop PN until the beginning of this year. The drugs I am taking are effexor 300mg, lyrica 50mg/3xday, and trazadone 50mg for sleep.
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Old 10-25-2015, 05:26 PM #5
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Lightbulb

The amount of B6 in a multivitamin is not very large.

But if you did not stop all vitamins several days before the test, it will show false elevations. The ranges were made with volunteers who were not taking any vitamins at all.

What was your B12 result?
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Old 10-25-2015, 06:14 PM #6
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@mrsD I unfortunately don't have access to my last lab results, but I'm getting more blood work done in the coming weeks. I can report back then.
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Old 11-11-2015, 04:23 AM #7
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Quote:
Originally Posted by itburns View Post
Hello,

In 2003 I had corrective surgery for scheuermann's kyphosis. My entire thoracic spine was fused.

About the beginning of this year I started experiencing loss of motor control in my right hand, along with tingling. I had an MRI of my cervical spine and it showed stenosis. In January of this year I decided to get a laminoplasty of my cervical spine.

The surgery resolved the issues in my right arm. I started to experience paresthesia in my abdomen, the sides of my groin, thighs, and tops of my feet. On my followup with my surgeon he told me my PN could not be a result of my laminoplasty.

I got an appointment with a neuro who prescribed me 50mg/3x a day and an MRI of my lumbar to see if that was causing my PN. Unfortunately all the metal from my kyphosis surgery obscured the results but I can post what they found below:

MRI SPINE LUMBAR WITHOUT CONTRAST: 9/4/2015 5:00 PM
HISTORY: PARESTHESIA, history of Scheuermann's kyphosis and corrective surgery at age 18 affecting his thoracic spine, paresthesias down his legs
COMPARISON: Lumbar spine MRI 01/11/2012
TECHNIQUE: Appropriate pulse sequences were employed in multiple planes.
FINDINGS:
This study assumes five lumbar type vertebra.
Alignment: Alignment is within normal limits.
Marrow: Significant susceptibility artifact emanates from spinal fusion hardware in the visualized thoracic spine extending to L2. Evaluation of these levels is essentially nondiagnostic.
Conus: Obscured by susceptibility artifact.
T12-L1 and L1-L2: These levels are obscured by susceptibility artifact and evaluation is nondiagnostic.
L2-L3: Partially obscured by susceptibility artifact. Sagittal images demonstrate no evidence of spinal canal or neural foraminal stenosis.
L3-L4: Trace disc bulge without spinal canal or neural foraminal stenosis. Mild bilateral facet degeneration.
L4-L5: Disc degeneration with mild loss of disc height. An annular disc bulge has a superimposed right paracentral protrusion/fissure. The disc material indents the ventral thecal sac without causing significant spinal canal stenosis. Mild bilateral foraminal encroachment is stable. Minimal facet degeneration.
L5-S1: Disc degeneration with mild loss of disc height. The previously seen left paracentral disc protrusion has resolved. A small annular disc bulge flattens the ventral thecal sac without causing spinal canal stenosis. Mild bilateral facet hypertrophy with slight right neural foraminal encroachment.
Sacrum: Normal appearance of the visualized portions of the sacrum, without evidence of acute fracture or suspicious lesion.
Soft tissues: The paraspinous soft tissues and visualized portions of the retroperitoneum are unremarkable.
IMPRESSION:
1. Interval resolution of the previously seen L5-S1 disc protrusion.
2. Mild degenerative disc disease L4-L5 and L5-S1 without spinal canal stenosis or nerve root impingement, otherwise unchanged.

The neuro told me there was no impingement and I assume the cause of my PN is unknown. I think something happened during my last surgery.

I'm wondering if now I have to deal with PN for the rest of my life and if it will only get worse.. I've been suffering from depression this whole year and was hospitalized for suicidal behavior. I'm currently getting Electro Shock Therapy and wondering if that affects my PN.

I have a followup with my neuro next week, as well as my surgeon. Is there anything I should be asking them?

Should I be taking supplements? Avoiding things like alcohol? Any advice you think would be helpful I would be happy to hear. Sorry this was so long.
i read up on scheuermann's kyphosis, it a pretty serious disorder, in male teens. I think the spinal damage from the kyphosis, or from the surgery is the cause of your Current pn. High B6 is toxic, and can also cause neuropathy as well.
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Old 11-11-2015, 07:47 AM #8
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Hi itburns,

There has been discussion regarding the relative safety of sphingolin on the Vitamins Forum as it is derived from bovine spinal cord. The risk of contamination and contraction of vCJD should infected source materials be used is high.

Here is a link MrsD found, warning of the risks:

http://www.centerforfoodsafety.org/i...in-supplements

Dave.
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Old 11-11-2015, 12:35 PM #9
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We all think so different don't we. I worry more about the lab meds and all their side effects. I'm glad I tried both these as the Burn is gone.
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Old 11-11-2015, 02:16 PM #10
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@neuroproblem yes, < 1% of the population gets scheuermann's. i guess i was one of the lucky few. why do you think the PN is caused by the kyphosis or the surgery? i didn't have signs of PN for years after my surgery for kyphosis. it wasn't until i had my surgery for the stenosis in my neck that i did. as far as the b6, all i was taking was a simple multivitamin. its strange to think that would cause my PN.

@englishdave i remember reading about mad cow potentially being in sphingolin. thanks for reminding me. i think i will just take the inosine for now, but i'll consult my neuro before i start taking it.
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