What Do Painful Jerks In Body After Suffering Spinal Lesion Indicate?

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Hello and welcome back! I am sorry that you haven't been doing well.

Those symptoms are a little puzzling. Considering the history of spinal cord injury, it might to a point explain the electric like jolts which can be a symptom of damage to posterior part of the cord (typically when bowing the head, called Lhermitte's sign). They can appear after some time from the injury, but still one year is too much and makes it doubtful to be only due to the old lesion.

Fasciculations on the other hand are even more difficult to explain by the spinal lesion. When due to neurologic conditions they are due to damage to the lower motor neurons, the ones leaving the cord to form peripheral nerves. Cervical cord damage would instead damage upper neuron fibers which have the opposite action to lower ones, their damage doesn't cause fasciculations. Their manifesting on the lips further more is not related to the spine at all.

So while I do not know what other signs your neurologist has noticed on his neurological examination, I believe he wants to make an MRI to search for some recent development like a herniated cervical disk.
With the EMG he wants to exclude lower motor neuron damage like from other conditions like ALS (amyotrophic lateral sclerosis) which can present fasciculations. Before you start panicking though I do not think the latter to be likely at all, it doesn't usually manifest at such early age, fasciculations do not become so widespread so quickly and frankly the possibility of you having to different conditions at the same time seems very remote. It is good you are doing it just in case, but if negative the cause for fasciculations must be searched in metabolic alteration (electrolyte changes like magnesium or calcium), thyroid dysfunction or when all rest negative anxiety might be a factor as well.

I remain at your disposal for further questions.

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Regarding Lyrica that shouldn't have any relation, if it has an effect on these symptoms should be a beneficial one.

So the muscle twitching has been going on for longer .... I still do not consider a cause such as whole new condition like als or other peripheral conditions likely anyway. Whether they could be considered part of healing process, well real fasciculations as I said are not typical, but the term twitching can be somewhat subjective as there are similar types of muscle contractions due to upper motor neuron damage like myoclonic jerks. Anyway the lip does exclude the spine as the cause for sure, its innervation is higher up.

So given such an inexplicably late occurrence of shock feelings and the twitching the MRI is necessary to exclude as I said disc herniation or demyelination.

Hopefully there are no new findings.

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Yes you are correct, I suggested disk disease after reading that report. It described a simple bulge which didn't cause any compression so that doesn't justify the symptoms, but since some time has passed the picture might have changed. It also mentions a congenitally narrower than usual spinal canal, which means there is less room to compensate and greater likelihood of compression in case there is a space occupying lesion (if there is such a lesion naturally).

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If you mean the neck pain radiating in the left shoulder mentioned in the past queries, I am afraid it is most probably related to the cord injury. Only if it is a recent onset pain could other hypothesis like disk disease be considered but if present since then it is to be considered a complication of the injury.

Regarding treatment Lyrica is an appropriate first choice drug. Dosage can still be increased to 600 mg. If no improvement is seen in such dosage then another alternative would be antidepressants. Don't be mistaken by their name, while initially developed for depression they were later found to have other benefits and are also a first choice drug for chronic neuropathic drug as an alternative to anticonvulsants like Lyrica.

I hope to have been of help.

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Hello and thank you for keeping in touch.

Regarding the first question about the scar, well I am sorry but I have to answer yes. Some scar is expected to remain. That doesn't mean that we do not expect improvement thanks to neurons forming new connections (new connection formation which can manifest those electrical sensations), but some damage to the old pathways remains.

As for the part of the radiculopathy, it means there is compression of a nerve root at that level which can cause pain, abnormal sensations, less commonly diminished strength of some muscles and fasciculation in the upper limb on that side (not other areas - and if the report doesn't speak of fasciculation perhaps those twitches are myoclonic jerks, can happen in spinal injury). Since it corresponds to the disc bulge level, it seems that bulge is causing nerve root compression now. The degree will have to be evaluated carefully to decide from the images whether to continue current therapy or at times consided surgery to relieve compression.

SEP means sensory evoked potentials, involves stimulation of a nerve and recording of the signal it generates. Interpretation depends on where it is measured, the nerve, the spine, the brain cortex so can't make much of that, but some alteration would be expected in your case both from radiculopathy as well as spinal lesion, so wouldn't make much of it.

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No, not directly.

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The C5 - C6 injury does not explain back pain. Its possible complications are either compression of cervical nerve root which would lead to pain in the neck and upper limb in the trajectory of the nerve (may radiate somewhat but not as far as lower back), or could cause compression of the spinal cord which doesn't cause pain but weakness of the limbs, sensation changes below that body level and urinary issues.

So it does not explain lower back pain. That might mean that there are some arthritic changes of the spine, perhaps accelerated due to the trauma as well. Also your MRI report spoke that you had a congenitally narrow canal (an issue you were born with, not due to trauma) which might mean you are more vulnerable, more prone to spinal problems and degenerative arthritic changes unfortunately.

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