Impaired Hand Post Accident, Get Intermittent Spasms, Flexing In Fingers. Neck MRI Shows Hypertrophy. Cause?
I am Dr. Prasad Akole (Critical Care Expert- http://bit.ly/Dr-Prasad-Akole) and am glad to address to your query here.
It is saddening to know your loss of function in left hand.
Did you have a crush injury or a sharp cut to the left limb?
Your symptoms are typical of parasthesiae (which are abnormal sensations perceived due to nerve damage).
As your scans and brachial plexus are reportedly normal, it is not due to central nerve affection.
I feel it is post-traumatic local neuropathy- compression or blunt/ crush injury to the nerve at the upper limb level.
It can be assessed by doing a NCV (Nerve Conduction Velocity) and not EMG (which is for muscle function- unless these two were combined).
Vertebral hypertrophy is unlikely the cause. Temperature changes felt are due to autonomic neuropathy/ parasthesia.
I would advise you to see a good neurologist and get this worked up. He/ she can derive the exact location of nerve injury by clinical and electrical tests.
Mild to moderate nerve affections may improve.
Ask if TENS (transcutaneous electrical nerve stimulation) locally could help?
Neuropathic pain is helped by gabapentin, neurotonics etc.
Sometimes plastic surgery is needed to repair the nerves.
I hope to have answered your query satisfactorily. I would be glad to answer any further queries. Take care and please keep me informed of your progress at http://bit.ly/Dr-Prasad-Akole
Good Luck! Do not loose hope....be perseverant.
It helps us to improve continuously if you could please write a rating review before you ‘accept’ and ‘close’ the query.
Thank you!!
Thanks for the details.
Your EMG is not normal as you mention.
Your tests exclude high lesions like cord or brachial plexus structurally.
Although the comment in the EMG says that there is possibility of upper motor neuron lesion (which is near the spinal cord segments).
This is little strange. Sudden jolting at the neck and shoulder causes brachial plexus stretch injury to various extent. MRI rules out structural damage. Functional deficit is indicated by tests.
You have sensory deficits and parasthesiae in the median nerve territory and weak activation of dorsal interosseous (on EMG) which is supplied by the ulnar nerve.
Initially I suspected lesion at the level lower than the elbow (? above the wrist). But actual detailed testing of muscle group by group is needed.
Mixed nerve injuries are possible.
Due to these confusing comments on the tests, I would advise you to get evaluated by an expert neurologist to find out the exact level of injury (near the hand or at the brachial plexus/ cord level). Results of the NCV/ EMG have to be interpreted in the light of clinical findings.
Online consultations have this limitation.
Treatment can be planned after accurate localization of the level of injury.
I hope you find this useful and get appropriate treatments.
Have a healthy life ahead !