Is this ALS?

[fallettap]

I tried to commit suicide 13 months ago by overdosing on Cymbalta/Strattera. One month after the suicide attempt I noticed weakness in my right shoulder/arm which is painfull after exsersise along with left leg weakness/heaviness only when wearing shoes vice flip flops. I visited a nuero 9 months later. I notice slight wasting in both areas but the nuero does not. I had a normal nuerological exam and a normal NCV on both areas. I had an EMG done on both areas which was normal except for increased motor unit amplitude and duration (12ms) and a slightly increased polyphasic potential (1+) on one area of my left leg (BicepsFemS). Right arm and shoulder EMG was completly normal. Is it possible to have ALS with these findings. I have read (Mr. Wright) that upper motor neuron (arm/shoulderweakness) symptoms do not show up on EMG's. But if you have ALS your lower motor neuron (leg) EMG results will show up dirty. My nuero cited the one area out of five tested was abnormal on my leg but that my overall study was normal and no evidence of active denervation on all muscles tested. Can someone out there explain what is going on? He is just recommending excersise.

 

[Zaphoon]

You are a little confused regarding upper and lower motor neurons. Upper motor neurons are in your brain/brain stem. When they die off, it results in muscle spasticity and hyper reflexes. Your lower motor neurons are located in spinal cord. When they die off, you experience weakness and muscle atrophy.

The message to move a muscle originates in the brain with upper motor neurons which communicate to lower motor neurons which communicate with the muscle. Your legs can be effected by both upper and lower as can your arms. Lower motor neuron damage can cause muscle wasting in any geographic area of the body.

 

[fallettap]

Thank you for clarifying that. From what you said my symptoms suggest lower motor nueron symptoms. Does that single finding on the leg EMG suggest ALS.

 

[trfogey]

Your neurologist answered your question -- "overall study was normal and no evidence of active denervation on all muscles tested." You should be rejoicing that you don't have ALS or any other serious neurological disorder. Yet here you are, asking a group of unqualified strangers to second guess your neurologist. Why? What makes you think we know better than your doctor does?

For what it's worth to you, since I am not a doctor, your symptoms don't sound like ALS to me. Give the exercise program a chance.

 

[handinhand]

I think it is fine to ask us and tell us your concerns.. All we can do it tell you what we have experienced ....I think you sound safe for now. I hope you can find peace with what your Dr. told you. We all wish so much that our Dr's had told us that... Just enjoy your life and live every day ... L

 

[fallettap]

I have started a excersise program with a physical therapist, but I have alot of pain the day after the excersise. Although there is no pain during the excersise period. When the neuro told me to excersise I was thrilled because after my suicide attempt I let everything go. But the pain with excersise bummed me out. That is when I dug deeper into my EMG and found this board, he also noted that this EMG does not rule out radicupathy (spelling) or some word like that. Also I have noticed on one of the post on this board that someone had ALS like symptoms after using Effexor which is a SSNRI. My overdose was on cymbalta a SSNRI also. I suffer from OCD which was cured when I overdosed. The reason why is before the overdose all my problems where in my mind and not real. Now I have lost a $66,000 a year job, my house (I have a restraing order against me), my wife, my family, my peace of mind for saftey (I have been threatened) and I think my health which is what I am trying to figure out. I now have real problems so OCD does not effect me. I am not one of these people (although I used to be which got me into this mess) that is worried about perceived weakness or perceived twitching. I had an area on my EMG that is consistant with ALS from what I have read and real weakness, but no fibs,facs and it was only one area out of many areas tested. I am just trying to confirm his finding so I can go on with the pathetic life I have created for myself. Thank you for replying to my post's.

 

[trfogey]

Given that drugs such as Cymbalta and Effexor are commonly prescribed to people who actually have ALS after they have been diagnosed, I don't think that family of drugs is a cause of ALS. Also, radiculopathy is a treatable condition that has nothing to do with ALS. Finally, it is not uncommon to have pain and soreness in your muscles when you start an exercise program.

So, stick with the program that your doctor has laid out for you and give it a chance to work. A single anecdotal case out of thousands of posts is not something you want to hang your emotional well-being upon. Good luck.