Which motor neurones control your muscles in your diaphram and stomach? Upper or Lower?

I go for two sleep studies in the next week. My stomach muscle seem to have gone away, I feel like I'm 5 monthes pregnant ( LOL). I have shortness of breath, so my doctor thinks I may need a Bipap at night..

Thanks... Lora
LUGG

Lora ... don't know about the motor neurons in the diaphram, but a BiPap is a good idea for any PALS. I don't think you need a sleep study to determine that. PALS get BiPaps not because we wake up during the night and lose sleep, but to let the diaphram rest, and assist in the work of pumping the lungs overnight. The longer you can keep your diaphram working, the better.

So, a dx of ALS alone should be enough of a reason for a BiPap.

Bethu ..

Thanks, the second sleep study they will be putting me on the Bipap machine to compare it to the 1st study. I was diagnosed with PLS in June, but am afraid that
i'm going into ALS...That is why I really would like to know if the lower neurones control the lung muscles...

I know of a few PLS people who have breathing problems but it seems like they have had PLS for years... The sooner I know if it's ALS the sooner I can deal with it accept it and get on with living the rest of my life.. I just hate the limbo.

Thanks.. Lora

Lora,

There's a common confusion between Upper Motor Neurons (UMN) and Lower Motor Neurons (LMN) and what they are and how they control muscles.

Every muscle is controlled by both a UMN and a LMN. It's a connected chain. The UMN is in your brain, and transforms the thought to move the muscle into a signal to the LMN, which relays the signal out to the muscle. For some muscles the LMN is in the brainstem (such as bulbar--mouth, tongue, swallowing), for other muscles the LMN is in the spine (arms, legs, diaphragm, etc.).

-Tom

Have you considered seeing a neurologist and having an EMG? This is worth paying attention to.
good luck,

Lora,

My understanding, like Tom's, is that both upper and lower motor neurons play a part in ALS. PALS with PLS tend to suffer from spasticity (sign of upper motor neuron damage) which presumably can affect the diaphragm (leading to paralysis of part or whole of it). I guess lower motor neuron involvement in PMA will result in atrophy of diaphragm. So, those with ALS may end up with both, those with PMA with atrophy and those with PLS with spasticity/paralysis.

Best wishes. D

I appreciate the explanation, I didn't realize it was a chain. Thank you Tom.
Beverley

Hey Tom and Danijela,

Those were excellent replies!

Zaphoon

Thank you everyone! I go see my pulmonary doctor on monday...I have appointments with my neurologist and the ALS clinic mid-November.
Both are trying to get my appointment moved up, if someone cancels. I really just want to get the proper diagnoses. I have been twitching more when at rest too. ......

The one thing these diseases make you do is get your life in order....I had a dumpster placed in my driveway, at the begiining of the week. I have cleaned all the junk out of the house, garage, and shed. I want to do things while I can, next is painting!
I would never take vacation in the summer, that's my jobs busy season... But I did this year, I took my girls ( 20 and 11) to the beach! We had a ball... Most important I have gotten more involved in church groups. I have always gone to church, but never made the time to join a womens group or a small study group... I have done both. It has really been a blessing. We are studying a book called " Working through Adversity" . The Lord knew I needed help with that!..

Thanks again for all your help. I will update you on Monday after my appointment. Lora

Hi, I wanted to tell you that the twitching can absolutely be from the misfiring of the nerves, hyper reflexes and the like. Do not stress about your dx. changing.

Pace yourself and don't over work as that will have a negative affect. Good to get things done while you can!

Just wanted to updat everyone. i went to pulmonary dr. - he said that the muscle weakness shown on my 1st pulmonary study test, is caused by lower motor neurons. He said that my Dx is ALS, he went through a 25 min talk about Vents, peg tubes,etc. Then he wanted to run anoher set of pulmonary studies before I left that day. My Mip and Mep scores stayed about the same, so now he is not sure if its ALS or still PLS.... The test were done only a month apart. He believes that if it were ALS then my results would have went down some.

I am still having shortnes of breath.... Would the test results really change that much within a month? he has ordered a AVAPs machine and a couph machine... I feel like I am on a roller coaster....

Were is Beaver Halls PA? What clinic do you go to? What was your FVC?

I believe Beaver Falls is in NW Pennsylvania, so both Cleveland Clinic and clinics in Pittsburgh would be a comfortable drive.

Icecreamlady,

Most doctors will wait for 3 to 6 months inbetween testing. I have a differential dx of PLS and if that is what I truly have, it fits as my progression is slow (not much change in the last 9 months). I do say, however, that any rate of progression is too fast.

So, to answer your question, one month inbetween testing probably wouldn't show much difference, particularly if you have something that is progressing slowly.

Zaphoon

Beaver Falls is about 45 minutes North of Pittsburgh. I go to Pittsburgh for all my doctor appointments. My FVC is normal. My Mip (63%) and Mep( 36%) are what really shows up as low. What the pulmonary doctor explained was that the mep and mep are the true value of muscle strength in my chest muscles... I'm confused.

I go to the ALS clinic mid Nov, and have an appointment with my neuro the first of Nov.... I seem to be getting short of breath more often, that is a concern...

Thanks, Lora