cervical spine lesion question

[gracefullyteaching]

Hello,

I stumbled across an article which discusses Cervican Spondylotic Myelopathy and the differential dianosis of ALS depending on symptoms. My understanding was that ALS patients will not have any lesions showing on MRIs. This is the first article I have read which says that a c-sine lesion should alert the physician to possible ALS. I will attached the link here if you are interested. I am now wondering how many of you had clear brains but a lesion on the c-spine?

Not sure if this should be under General Questions-- feel free to move it, but since I am undiagnosed, I thought I would start here.

As always, replies appreciated.
Cervical Spondylotic Myelopathy: A Common Cause of Spinal Cord Dysfunction in Older Persons - September 1, 2000 - American Family Physician

 

[Alyoop]

Differential diagnosis: The process of weighing the probability of one disease versus that of other diseases possibly accounting for a patient's illness. The differential diagnosis of rhinitis (a runny nose) includes allergic rhinitis (hayfever), the abuse of nasal decongestants and, of course, the common cold.

You have misunderstood what a differential diagnosis is. When a patient fronts up to a doctor with symptoms and of some thing amiss, the doctor forms a list of potential conditions that may me the cause of the medical problem. Through clinical examination, observation and tests, they can then slowly deletes conditions from their differential diagnosis " list" until they have the hopefully correct diagnosis.

An MRI will be clear in a patient with als. It will not be in a patient with cervical disc disease.

I am notoriously bad at explaing things, so hope this helps a bit.
Aly

 

[Zaphoon]

I read the link and enjoyed it. It did not state what you think it stated regarding c-spine lesions and ALS, as far as I could tell.

 

[island]

If the Mri clean in Als patients why have I read in searching the net,yes I know dr. Google is not the doctor to seak,but this was on Wikipedia :
MRI (parasagittal FLAIR) demonstrates increased T2 signal within the posterior part of the internal capsule and can be tracked to the subcortical white matter of the motor cortex, outlining the corticospinal tract, consistent with the clinical diagnosis of ALS.
And I've read some of ALS patients blogs that have said that this was found on there MRI.
I was just wondering

 

[trfogey]

I think there may be an error in table 3 in the article. Under MRI findings, both ALS and CSM have the entry "Spondylosis". I don't think that ALS requires spondylosis, but given that spondylosis is so prevalent in the prime "age of onset" demographic for ALS, I wouldn't be surprised if a lot of PALS had it when their ALS began. CSM requires it however.

Second, spondylosis is not a "lesion". It's a form of mechanical compression. It shows up on MRI as a narrowing of the soft tissue of the spinal cord. I'm not sure why the original poster is calling it a lesion, since that word appears nowhere in the article.

Hope this helps.

 

[gracefullyteaching]

Thank you for the clarification. You are right, there is no mention of lesions in the article. Somehow this article came up while I was researching c-spine lesions. Not sure why since it did not mention the topic. Table 3 did confuse me. Thanks for your time!

 

[olly]

just to clarify als is effected by the umn's in the brain and spinal cord...........grey matter,as well as lmn's.
mri's at this time are not able to pick up lesions in the grey matter,something different or stronger has yet to be developed that will show early damage in these areas making diagnosis easier.
on a clinical exam a neuro would be able to tell were i have umn lesions but a mri would be normal.......grey matter.

 

[notme]

just to clarify als is effected by the umn's in the brain and spinal cord...........grey matter,as well as lmn's.
mri's at this time are not able to pick up lesions in the grey matter,something different or stronger has yet to be developed that will show early damage in these areas making diagnosis easier.
on a clinical exam a neuro would be able to tell were i have umn lesions but a mri would be normal.......grey matter.

Pretty much exactly what my neuro told me, olly. UMN signs are clinically found. She isn't expecting to find anything on my brain MRI...it's being done to rule out ms .