Presented by:  Dr. Robert Brownstone, Neurosurgeon, Halifax

Age:  25

Sex:  Male

History: 

• 1995 – diving accident.  Quadriplegia: C7 motor complete, able to tell when someone is touching his legs but can’t discriminate temperature, etc.

• “Hypersensitive” on right side.

• C6/7 Anterior Fusion. Infection, repeat surgery

• 1998 - Leg pain right > left.

• Burning. Constant.  Aggravated by neck movement.  Lost 40lbs

• Pain extended to groin

• Began losing some (slight) sensation and strength in his left arm. 

• MRI done,  showed C6 to T6 Syrinx .

• 1998 - syringo-subarachnoid shunt done.

• Neurological deterioration was halted

• Pain persisted and progressed

• 1999- Pain became worse shooting into legs and left arm.

• Spasticity in legs.

• Self caltheterigation (could feel full bladder)

Dec 2000

• Pain persists

• seen in pain clinic

• no motor function below C₇

• Can sense touch in legs.

Current Medication:

• baclofen 20 tid and 40 at hs

• oxybutinin 5 qid

• valium 5 qid

• neurontin 400 tid (adverse effects at higher doses: not helping)

• tegretol CR 400 tid (Helping a bit)

• methadone 15 qid (unsure if beneficial)

• has tried acupuncture (not helpful)

Questions:  Now what?