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FF28

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Jan 8, 2013
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Learn about ALS
Country
US
State
Nevada
City
Reno
Hi, I'm a heathy 28yo male. I'm a firefighter/paramedic with a wife and 2 kids. Here are my symptoms for over a year:

-Muscle twitching all over including the tongue
-Feet, Calf and hand sorness and cramping
-Knee weakness & Giving out
-Difficulty swallowing (no choking but food sometimes get caught)
-Abnormal (feel like I'm not breathing deep enough so I sigh a lot)
-Slurred speech

-Last month I developed hyperreflexia (knees)
-Last month I had a bout of acending numbness that went from both feet to my knees over 5 days. Also around the 5 day mark I had patchy numbness throughout my upper body and head. Over the next 5 days it went away the same way it came on. This has been the only occurance of this type of feeling.

This prompted me to see a doctor and on evaluation I could not feel my left foot but I could feel most everything else with a decreased sense. Also hyperreflexia in both knees. Passed all other tests.

-EMG Normal
-MRI Normal
-Strength is normal (feels more like muscle fatigue)
-Overly sore outter thumb muscle for no reason

Neurologist says I have a LMN problem but I'm showing no signs of a UMN problem. I'm getting a CT and an echocardiogram done in a few days. Does anyone have any advise or similar experiance they could share?
 
Keep up with your neuro.

Some of what you posted seems contradictory, but it might just be confusing terms he had thrown out there. At any rate, with only UMN or LMN, it isn't ALS - ALS is a combination of the two, so that's good news. And generally bulbar ALS would not skip your arms and midsection to start playing around in your legs. ALS also doesn't cause numbness. So that's not something I would invest a lot of worrying in at this juncture.

There are lots of less bad diseases out there that cause symptoms much closer to yours, Isaac's syndrome for instance. Just get through the tests and let him tell you, he has a much better understanding of your situation than we do.
 
Hi, I don't understand why your neuro said you have a LMN problem if your EMG is clear. Usually a normal EMG means no LMN problems. Some symptoms that you're sharing are similar to mine: twitching all over, feet and calf soreness and knee weakness. I have hyperreflexia too but not only in my knees also in my arms. I had a clear EMG and my neuro said no LMN problems at the moment but maybe something UMN related cause of the hyperreflexia.......anyway I'm still undiagnosed and waiting in this Limbo. Keep me updated, you're so young, I hope we'll have answers asap.
 
Thanks for the replys. I guess I'm mostly concerned with my Bulbar symptoms. From what I have been reading it seems variable when the doctor diagnosis someone with Bulbar ALS. Some people seem to have isolated Bulbar type symptoms and they recieve a diagnosis of Bulbar ALS. And others say you need symptoms in 3 or more extremities. So at what point does it make the diagnosis of ALS likely? And yes my symptoms are confusing but I guess that's why I'm here. I'm just confused and hoping someone can shed some light on this. The people on here have a ton of knowledge do anything helps! Thanks again.
 
Check out the El Escorial Criteria for ALS dia g n o sis. Reading that may shed some light .
 
I believe that with clear EMGs nobody can diagnose you with ALS. To have an ALS diagnosis you must show signs of both UMN and LMN problems....did you have the EMG in your tongue face and neck ? I know that patients with bulbar onset ALS have dirty EMG in their tongue face and neck before having signs in their limbs.
 
Perhaps you could ask your nuero about having a swallow test. There are a few illnesses besides als that could affect speech/swallowing. Hoping you continue with a 'non-ALS' diagnosis.
 
HI

I'm a little confused by your doctors statements, to be honest. Hyper reflexes are considered UMN in nature. Weakness and atrophy (and thus, EMG changes) are LMN signs.

The progressive ascending numbness isn't ALS. Have they tested you for any potential neuropathies and deficiencies like b-12?

As a firefighter, there is a chance you've been exposed to something in a fire perhaps? Has that been investigate, too?

Good luck and keep working with your neuro!

Who is noticing the 'slurred speech' you or your coworkers?
 
Please don't jump to the bulbar ALS conclusion. My husband is at the end of his run with bulbar ALS and he is just now losing his legs and his arms are strong. There are so many fixable things that may be wrong, don't dismiss them and take this trip to Hell voluntarily. If you have a clean EMG, please just keep up with your neurologist and let him get to the bottom of this. Do it for your sanity, and your wife, and most of all, do it for your kids. Don't let fear run your house.
 
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