Other Chronic CES-I with Unexplained Cardiovascular Disorders - Are these related?

Because my recent EMG testing diagnosed chronic nerve root disfunction at L5-S1, I’m wondering if this might be related to my many years of unexplainable cardiovascular abnormalities, bradycardia and incomplete heart-block — tests found no cause. I’ve had no back injuries and very little back pain, if only, occasional sciatica.

As for my CES-I symptoms, both legs though mostly my right leg, have gradually weakened over the past decade with very little if any sensory deficits. What I experience, now, seems more like an awkward lag in my gait with a continuing balance disorder that rehab hasn’t improved.

At first, I thought my ongoing awkward gait was likely an after-effect of my past cerebellar tumor, removed in 2018 — but then, my mostly bilateral right leg weakness was first noticed in 2008. Even in 2013, I was told my brain tumor was very small and asymptomatic. So, I'm thinking my CES-I was present in 2008. Then too, when my brain tumor was resected in 2018 my leg weakness was unchanged. Last year, my brain MRI looked very good and couldn’t explain my ongoing leg weakness thus, the EMG was ordered.

If my upcoming MRI reveals a tumor, I have to wonder, if, it might be similar to my resected brain tumor, as I've read that, these tumors can occur in clusters. They’re also extremely slow-growing, present at birth, benign with connections to the nervous system.

This makes my wonder if my brain-body communications might be faulty thus, manifesting symptoms. I suspect, I’ll be told I need surgery.
 

Sideways

Moderator
I suspect, I’ll be told I need surgery.
L5/S1 is very low down in the base of your spine. The nerves down there control things like our legs, feet and bowels. Whether or not surgery is required very much depends on what's going on in your spine, and what's causing the nerves to pack it in.

For example, there are auto-immune disorders that can mess with the ability of nerves to communicate effectively with parts of the body. Treatment for those? Isn't surgery - it can be things like immunoglobulin therapy (think: hooked up to an IV for a few hours every few weeks, simples!).

Very definitely you should consult a specialist, probably a neurologist, but speak to your GP. Nerve problems that show signs of degeneration (it's slowly getting worse over time) can be really serious, but also easily treatable. If you're noticing something like foot drop in your gait, even if there's no pain yet? It's definitely time for a specialist opinion. To get treatment before it rises to the level of chronic pain.

While issues with the nerves at the L5/S1 level of your spine is way too low to be causing issues with your lungs, that doesn't mean that the underlying cause of that nerve damage is irrelevant to your breathing issues. Because again, if there's spinal degeneration, or an immune system issue going on, or even something like a vitamin deficiency, that could well be effecting (and damaging) nerves in other levels of your spine, as well as other parts of your body.

Nerve issues can be incredibly dramatic in terms of function. When we get nerve issues, oftentimes the consequent diagnosis can be really scary. Because degenerating nerves, left untreated, goes to pretty awful places (like wheelchairs and adult nappies and chronic pain).

But - diagnosis is something to seek out, because so many of the conditions that cause nerve degeneration have very straightforward and extremely effective treatment, and surgery is very often not required, depending on the cause. Which is all good news, and reason to invest in quality medical advice.
 
Thank you for your info @Sideways I might be getting ahead of myself in looking for answers for my CES. Last year my PCP suggested I see a neurologist after noticing abnormal leg reflexes. My neurologist then ordered an MRI of my neck, then my leg EMG, now the lumbar MRI. Muscle strength exercises showed very little improvement.

Apparently, my past cerebellar brain tumor has masked my developing CES-I. My motor functions and strength above lumbar L5-S1 seem quite normal to me. Yet below L5-S1 I’m lacking integration -- where some leg muscle work better than others.

The foot-drop might slowly be developing, as these muscles are in that same effected region — tripping over nothing or tripping while climbing a staircase could be an example.

No wheelchair nor other devices, fortunately. I'm now 75 and certainly dread losing my independence. Sometimes strangers look at me, as if, they’re thinking I’ve had too many drinks. But no, it’s my balance. When I walk I’ll often feel as if, I have bungee cords loosely tied or tangled around my ankles.

As for voiding, I’m fine as long as I remember not to wait too long. Retention, however, is a far more serious medical emergency. I know to watch for it.

My brain tumor (since removed) had interfered with my breathing rhythm a few times. I’d just suddenly take a very deep breath for no apparent reason or I’d suddenly upchuck, as an uncontrolled reflex. This occurred just days or weeks before my coma (ventricles were enlarged, blocking CSF, cause was tumor)

It seems like my brain is unable to communicate with my legs — and if, this communication could be improved my balance might then also improve. But I’ve always had symptoms, such as, Raynaud’s syndrome, my doctors couldn’t explain.
 
My recent EMG and MRI reported that neural foraminal stenosis is severely compressing my nerve-roots at L4-L5 and L5-S1 on the right side. The other foramen canals also indicate stenosis though moderate to mild. Some of this stenosis extends into the spinal canal and is severe bilaterally (para-central) at L4-L5. Fortunately, no abnormal enhancements nor tumors were found. The MRI reported my cauda equina as unremarkable.

So, I’m be seeing a surgeon soon while researching surgery procedures online. Three family members recently advised me not to read ‘Dr. Google.’ Yet I want to be informed. What’s accurate depends on the source. It certainly was scary reading my MRI report online -- I could feel my heart pounding. However, I do think that my doctors would first talk to me personally, by phone if, my report were disturbing.

Being in my mid 70’s, this slowly developing spinal stenosis isn’t unusual. It just never occurred to me that my walking and balance difficulties were related to a nerve-root compression in my lower back — especially since I’ve had only mild back pain. But before this recent EMG testing, I had not way of knowing.

Always fearing that I might lose my balance and fall has only added to my chronic stress. Now I know why my muscle strengthening exercises have offered me little improvement.
 
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Sideways

Moderator
Being in my mid 70’s, this slowly developing spinal stenosis isn’t unusual.
Very definitely. If you've made it to 70 then you're doing really well!
Now I know why my muscle strengthening exercises have offered me little improvement.
Life changing! Strengthening exercises can be the difference between having good function and manageable pain, and not being able to walk at all.

Glad you now have some clear answers!
 
Just to follow-up — In regarding to my lumbar stenosis and nerve-root compression — the neurosurgeon that I saw last week suggested fusion of my L4 to L5 with no other option but to live with it. Fortunately, I don’t have much back pain yet. And having lost 60 pounds over the past year on Keto has certainly helps.

But I don’t like this fusion idea, especially since my other lumbar vertebra also indicate stenosis. He didn’t seem too concerned about the severe nerve-compression reported in my recent EMG and MRI. He also said, he hasn’t found EMG testing to be very reliable.

He thinks my balance disorder stems from my past 2018 brain tumor. Yet I first noticed a subtle balance and leg weakness back in 2008. This was 10 years before my brain tumor resection. Even in 2014, I was told my tumor was small and asymptomatic. In 2016, I was beginning to lose my balance when digging up my lawn with a shovel. Lifting my right leg off the ground for more than 2 seconds was/is difficult, as I’ll immediately begin to wobble and fall over. My left leg function has always been slightly better.

The muscle movements above my lumbar spine have always been extremely well coordinated, if, only slightly slower than the norm. (I know because I like to 'hand dance' to music where one hand will rapidly mirror the the other hand's movements -- this I couldn't do if, my arm, shoulders and hand coordinations were faulty like my leg and hip movements. Yet here it’s a different story where this movement weakness and lag have been worsening over the past 15 years.

Strength training doesn’t help — I wish, I could make my family understand this fact. I know because I’ve tried and exercising has it’s limitations. Perhaps, my family are trying to offer me some encouragement and yet, their lack of understanding only angers me. If I’m correct, this is due to my neuro-foraminal stenosis. The mid 2021 MRI of my brain also reported that my brain appeared to be asymptomatic.

On the up-side, there’s an spinal implant currently being tested which might soon be made available to many suffering with lumbar stenosis — a far better option than fusion.
 

Freddyt

MyPTSD Pro
Some can. There is a study underway at the University of Calgary into the possible mechanism that causes chronic illness. PTSD seems to play a part in it and it seems to indicate why CBD alieviets some symptoms.

I have a chronic illness as well and I find more and more as I get a handle on my PTSD that the two affect each other a whole lot too. Worst bit is all the stuff where I have the same symptom from multiple causes. Makes assessing each separately much more difficult at times.
 
Some can. There is a study underway at the University of Calgary into the possible mechanism that causes chronic illness. PTSD seems to play a part in it and it seems to indicate why CBD alieviets some symptoms.

I have a chronic illness as well and I find more and more as I get a handle on my PTSD that the two affect each other a whole lot too. Worst bit is all the stuff where I have the same symptom from multiple causes. Makes assessing each separately much more difficult at times.
CBD, this is short for Cannabidol. I hope these researchers find better treatments, not only for the pain but for the underlying conditions, as well. I seem to have some auto-ammunity issues, myself.

But about this issue of chronic inflammation or whatever — many years ago, my T once made a comment about chronic pain. I then got the impression that he was suggesting that, chronic body pain might serve a purpose, in that, it diverts one’s attention away from their more painful thoughts and feelings. Whether that’s true or not, I wouldn’t know. I just thought his theory was interesting. And I agree, PTSD has a lot to do with it.
 
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