Upper/lower motor question, please

[SilverLining]

Hi,

I was reading about upper/lower motor symptoms.

Would anyone know,

Can they come on gradual or will they be presant at the time of weakness?

If weakness was presant in a limb & emg was normal & Dr did not note any upper/lower motor nueron symptoms, then weakness is not due to als because no upper or lower motor symptoms are preasant but is it possible that they come soon after?

Or does upper lower motor symptoms show at same time as weakness?

thankyou so much, again

 

[trfogey]

Weakness can be caused by things other than motor neuron death. That having been said, here's the following , cut-and-pasted from your other thread.

--------
Can they come on gradual or will they be presant at the time of weakness?

Once again, it depends on the cause. Compare polio, which destroys lower motor neurons in a matter of hours or days, to ALS, where motor neuron destruction is usually extended over a period of years. Until you know what the cause is and get some measurement of the individual's specific rate of progression, you can't make any useful predictions.
--------

Theoretically, a process causing lower motor neuron death should be detectable using an EMG before visible symptoms such as clinical weakness, flaccid paralysis, or atrophy can be seen. I don't know of any method to detect upper motor neuron problems at an equivalent level. However, I suspect that the particulars of the destructive processes are so closely tied to the individual host environment that you would have very limited predictive capacity about the future course of the destructive process.

In other words, you might be able to know that your left arm was under attack and still have no way of knowing how long the battle will last or what the eventual outcome will be.

Hope this helps.

 

[wright]

Here's the deal, SilverLining

The weakness you describe (i.e. the inability to move your toe) would be a "lower motor neuron" type weakness . . . and if your EMG was clean . . . that means it wasn't due to any type of lower motor neuron problem (especially not ALS) or to any neurological problem for that matter. It's as simple as that.

The EMG cannot detect upper motor neuron problems and upper motor neuron dysfunction can cause weakness . . . however . . . the weakness caused by upper motor neuron dysfunction would be due more to spasticity and stiffness AND there would be other upper motor neuron symptoms and signs present. These signs and symptoms would include very brisk reflexes, primitive reflexes (e.g. positive Babinski, Hoffman, etc.), etc. All of the upper motor neuron signs and symptoms are detected with a clinical exam and your clinical exam was fine.

What does all of this mean? You have no lower motor neuron problems and you have no upper motor neuron problems. What does that mean? That means that nothing about your story points toward ALS . . . not one thing. What does that mean? It means you really need to move away from these ALS thoughts. It isn't healthy and it isn't warranted in the least. Be done with this. I wish you peace.

 

[SilverLining]

TY Trfogey & Wright for clarifying this.
I feel much better knowing that I can put als out of my head. My fear was, of course, not being able to move my toe was als but if thats been ruled out, then I have no reason to worry about this Peticuliar weakness turning into als, right?

TY!

 

[sadiemae]

RIGHT Congrats