23 Year Old Male with Neurological Condition

[bduritsch]

Basically, about 5 years ago while I was in high school
I was a member of the marching band. We used to have
to snap our necks into certain positions during the drills.
One time I may have caused injury to my neck, but I
am not sure. All I remember was my neck becoming
bulgy, stiff, and in pain for awhile. Ever since that incident
I have heard noises like little pops and cracks every
now and then while laying down and doing other things.
This may or may not tie into the rest of my story...

A few years ago, I was diagnosed with having an episode
of mono. Apparently it somehow caused me to lose
sensation in my skin, and made me feel like I was wearing
thin gloves all over my body. There was never a definitive
diagnosis for this either, but it was called peripheral neuropathy.

Anyway, about 6 weeks ago I noticed upon waking up
from bed that I had an intense ringing in my ears
accompanied by a feeling of fullness/pressure in both.
Quickly I met with my ENT doctor, and he prescribed me
with some steroids and vitamins to see if the hearing loss
could be helped. He also set me up with an audiologist,
who basically gave me a diagram indicating a slight "cookie
bite" form where I had some trouble with the mid to high
frequencies in my hearing. The ENT said it was probably
a virus that caused this and it would go away soon, but it
hasn't.

So things went on pretty normal and I have a constant
tinnitus in both my ears that won't go away. My ENT now
believes it was caused by a virus, but still not sure. A few
days ago I noticed that my face felt like it was numb, almost
like a novacaine type feeling. Pretty soon I saw that it was
similar elsewhere in my body, (arms, legs, back, neck).
This freaked me out and so I went to the Emergency Room
on Friday. They let me go with telling me that it was likely
just an anxiety attack, but I told them I was never diagnosed
with any anxiety.

After a few days with these same feelings, I started having
trouble walking on my right leg. It just felt like I couldn't
figure out where to place my foot each time I put pressure
on it. When closing my eyes it was difficult for me to know
where my limbs were located in space. I went back to the
hospital and they ran a CT scan of the brain and eventually
an MRI of the brain which both came back normal.

However, upon meeting with a neurologist he couldn't figure
out what I have, so he ordered up some blood tests and a
cervical and thoracic spine MRI. The blood tests all were
normal, so my neurologist now thinks it could be a "chemical
imbalance" but the meds he gave me aren't helping.

Here are the results of the spine MRI (brain one was normal) :

Findings:
MR CERVICAL SPINE WITHOUT AND WITH CONTRAST, 4/6/09 @ 6:31 PM:


CLINICAL HISTORY:
23-year-old male with numbness in muscles, sensitivity all over
body.


TECHNIQUE:
Axial T2, T1 and post contrast T1-weighted images were obtained, as
well as sagittal T1, T2, proton density, STIR and post contrast
T1-weighted images.


FINDINGS:
No prior exam is available for comparison.


There is motion artifact on multiple sequences which slightly limits
evaluation. The normal cervical lordosis is grossly maintained with no
acute fracture or subluxation appreciated. Prevertebral soft tissues
appear unremarkable with no abnormal paraspinous collections or masses
appreciated. No geographic marrow lesion is identified. There is mild
loss of disc signal and disc height at the C3-C4 levels, though no disc
bulge, neural foraminal stenosis or central canal stenosis is seen.
Atlanto-axial and atlanto-occipital articulations are grossly
maintained. The posterior fossa is normal in configuration.


At C5-6, there is a mild broad-based generalized disc bulge which is
slightly greatest centrally. This causes anterior effacement of the
thecal sac, though it does not contact the cord and does not cause
significant central canal stenosis. No significant neural foraminal
stenosis is seen at this level, either.


The C6-7 and C7-T1 levels appear unremarkable.


There is a punctate area of increased T2 signal within the central
cord at the C4 level. It is located at the very center of the cord and
is appreciated on axial image 10-33; this is most consistent with a
punctate syrinx or focal dilatation of the central canal of the spinal
cord. However, this measures only 1-2 mm in size and is of
questionable significance. No other areas of abnormal T2 cord signal
are present. No abnormal areas of enhancement are identified. On T1
images, there appears to be normal signal flow voids within the
bilateral vertebral arteries with the left vertebral artery slightly
dominant.


IMPRESSION:


MILD DEGENERATIVE DISC DISEASE WITHOUT SIGNIFICANT CENTRAL CANAL
STENOSIS OR CORD EDEMA. PUNCTATE AREA OF DILATATION OF THE CENTRAL
CANAL IN THE SPINAL CORD IS OF QUESTIONABLE SIGNIFICANCE, LOCATED AT
THE C4 LEVEL. NO AREAS OF ABNORMAL ENHANCEMENT OR CORD SIGNAL TO
SUGGEST INVOLVEMENT OF IMS.*** Final *** Trans On: 04/06/2009 21:1by: SEE


Findings:
MR THORACIC SPINE WITH AND WITHOUT CONTRAST: 4/6/09 at 6:31 p.m.


CLINICAL HISTORY: 23 year old male with dizziness and numbness.


There is concern for multiple sclerosis.


TECHNIQUE: Sagittal T2, T1, proton density, STIR and post contrast
T1-weighted images were obtained as well as axial T1, T2 and post
contrast T1-weighted images.


FINDINGS: No geographic marrow lesions are identified. The
vertebral heights are maintained. No acute fracture or subluxation
identified. There is some minimal loss of disc signal within upper
thoracic disc levels though overall disc heights are maintained. No
central canal or neural foraminal stenosis is present. No abnormal
areas of T2 cord signal are present within the cord. No epidural mass
or hematoma is identified. No abnormal areas of enhancement are seen.
Thoracic aorta appears unremarkable in the visualized portions with no
aneurysm or dissection.


IMPRESSION: UNREMARKABLE APPEARANCE OF THORACIC SPINE WITH TRACE
UPPER THORACIC MINIMAL DEGENERATIVE DISC DISEASE.*** Final *** Trans On: 04/06/2009 21:4by: MAZ