Tagged: TMJ and cranial nerve
EricNeckParticipantApril 17, 2019 at 6:49 pmPost count: 8
Hi Dr. Corenman,
I have issues with what I think has to do with my neck and was hoping you would be able to answer some questions and point me to the right direction of where I should take this.
– 33 year old male, athletically fit.
– Long standing (longer than 15 years) issues of neck dysfunction meaning neck muscle pain, fatigue, tightness and headaches.
– Long history (longer than 15 years) of TMJD issues requiring splint wearing for sleep
– Previous X-rays show “cervical kyphosis likely due to musculature” as per radiologist report
– Has been practicing the martial art of brazilian jiu-jitsu (BJJ) off and on for 2.5 years. Think of BJJ as wrestling with a lot more chokes and submissions.
History of Symptoms/complaints
– After a hard sparring session in BJJ in Feb, 2018 a day or so later I felt some moderate pain in the left, upper anterior part of my throat (possibly the hyoid bone area).
– With this, I had off/on sensations of “dizziness” (by dizziness, I mean minor sensations of disorientation or kind of “floating like” feeling) for a few months.
– There was no vomiting, no vertigo, no significant scalp, neck or facial pain. No horner’s syndrome or other stroke like symptoms.
– I did feel more “tension” and tightness into my left neck into my face. I also had tingling sensations go up from the left side of the front of my neck into the lower face.
– The throat pain went away over about 8 weeks, the “dizziness” went on for a few months but subsided months later.
– I never got an xray for it or imaging done. I do work with an neurologist and asked him for his opinion. He didn’t think I had a dissection of one of the cervical arteries but said I could take baby ASA for a few months if I was worried. He said if symptoms persisted, I could do an MRI. I never went to do the MRI.
– The neck tension into my face persisted even when I took a few months off of BJJ. This tension is new from the chronic issues I’ve had in the past.
Fast forward to today
– I have had periods of not training BJJ for 1-2 months due to other injuries.
– My chronic neck and TMJD issues persist. I’ve consistently had the left sided neck tension even when not training BJJ. I’ve been having this difficult to pinpoint altered sensation somewhere around the left side of my mouth perhaps originating from my TMJ? I also still get the tingling sensations up the left side of my anterior neck. Also, I cannot open/close my mouth without a loud double click of my TMJ.
– I have started training BJJ again 2-3x a week but most recently after training, I’ve started experiencing the dizziness symptoms again. No vertigo but just a “floating” sensation.”
– I’ve also had sensations of intermittent “wet” and tingling sensations in my left wrist and shoulder. This happens maybe a few times a day.
Plan going forward
I think this has persisted long enough that I should get at least a cervical MRI done. I will pay for this out of my own pocket and if there’s something abnormal, I will ask my GP to refer me to a neurologist or neurosurgeon. In your opinion, is there any difference between a 1.5T or a 3T MRI for my situation? I have the option of going to either MRI centre.
I’ll also be getting an examination by a dentist who specializes in oral medicine and oral pathology and TMJD issues.
I know it’s hard for you to speculate what I could have without seeing me in person and doing more diagnostic tests but based on the above symptoms, what do you think this could be? I think any sort of dissection would be highly unlikely as it’s technically been 14 months. Do you think this could be something as simple as a TMJD issue that got worse with BJJ? Or is it more likely that I have some sort of disk herniation especially with my cervical kypphosis.
Thank you for reading this and I hope to get your opinion so I know how to direct my care.EricNeckParticipantApril 17, 2019 at 8:09 pmPost count: 8
Edit: I also forgot to mention that over the past 2 months or so, I’ve started feeling a “lump” in my throat on most days. There’s no palpable mass or throat pain or difficulty swallowing.Donald Corenman, MD, DCModeratorApril 21, 2019 at 12:32 pmPost count: 6661
You have symptoms more referable to cranial nerve involvement than cervical spine problems but the cervical spine needs to be ruled out by an MRI. For the neck, the strength of the magnet (“is there any difference between a 1.5T or a 3T MRI for my situation”) is not as important but if you can get a 3T, that would be better. It is really the technician that makes a big difference.
Your symptoms “I cannot open/close my mouth without a loud double click of my TMJ….There was no vomiting, no vertigo, no significant scalp, neck or facial pain. No horner’s syndrome or other stroke like symptoms” indicate the TMJ is malfunctioning. This joint disorder can cause some of your symptoms but not all. I do think a neurologist (not a neurosurgeon) would be a good first stop but maybe an ENT specialist who specializes in TMJ syndrome whole be a good stop too.
Dr. CorenmanPLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.EricNeckParticipantApril 21, 2019 at 1:16 pmPost count: 8
Thank you for taking your time to reply.
Another symptom I forgot to mention was every few weeks or so, I would get twitching under my left eyeblid that would sustain for a few days. Not sure if that’s related to the overall sympmtoms.
I’ll get the cervical MRI first and go from there.
Thanks again for your time and opinion.EricNeckParticipantMay 4, 2019 at 4:05 pmPost count: 8
Hi Dr. Corenman,
I got the MRI at 1.5T. The radiologist report won’t come for a few days so I have a few questions in the meanwhile knowing that I may not get a complete answer because you don’t have access to the full images:
1. How is the overall quality of the images based on the images below? Are they high quality and diagnostically sufficient?
2. I have attached an T2 weighted axial view at the level of C6. The technologist said she saw something here and I have marked it at the 7.9mm mark right around the area of the left vertebral artery. What is this white object that is sticking out that’s not on the right side? Could it be related to my symptoms?
3. How does the overall sagittal view look?
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