Is it ALS?

[alex34]

Hi to all members of forum. Here is the my story about my spthoms.
I m 34 years old and male. My problem started almost 2 months ago by weakness on my one feet. Following to it twitching, stifness showed itself. Finally i visited a doctor and she wanted back mri and emg test. According to results i have begining of hernia and it effects L4 and L5 part. Emg result is complety clean. But weakness become high and even when i lay down on the bed i feel weakness on my feet, its so strange. Then went to different doctor and wanted new emg after 20 days later.

This emg results are not okay for me. It says all signals normal but in L4 L5 area giant mup watched. those mups eurhythmic with chronic radiculer changing.

I confused and doctor said its about your back not any reason and go to another department for treat your back problem. But in another department doctor said its not a big deal and your spthoms reasons are not your back. I really stucked.

Then i learned it in Als giant mups a kind of spthom of this ilness in the begining. I really dont understand. Why 20 days ago emg was clean if its a chronic problem?

 

[Nikki J]

Your EMG and symptoms are consistent with this being your back. Those MUPs are nonspecific and are not anything to worry about. Where are you getting the informations they are the beginning of ALS? From reading the posts here of other undiagnosed worriers?
Why did they not show before? It seems like EMGs should be cut and dried but there is difference between examiners in technique and in interpretation. But neither EMG is anything to worry about re ALS and you were told that by the neurologist

 

[alex34]

Nikki thank you so much for the posting u answered to my question. But i asked about giant mups to some nerology professors and they said yes is als it is a kind of signal. Coz giant mups mean somethings are holding to nerves and its a sypthom. Thats the reason why i am worry. Second thing is that doctor said about my back its not a so big problem coz your hernias level is not so so high and hernia problem cant give your those giant mups. So normally i m confused.

 

[Nikki J]

I strongly suspect that you did either did not hear all those professors said or you asked a limited question about MUPs in ALS. There are Large MUPS in ALS yes but there are also other findings which you did not have so it is not ALS further you do have an abnormal imaging study in the relevant area. You choose to believe the orthopedist did discount the neurologist and think you have a neurological disease that he/ she told you no ( and this was apparently your second neurological opinion did you seek a second orthopedic opinion?). Believe what you will but there have been people here over the years who insisted their large MUPs were beginning ALS who remained undiagnosed for an extended period before they left here

 

[alex34]

Nikki i understand you perfectly but i hope you understand me too.
I swear on god i asked to few nerology professor and said that what does it mean giant mup, why i have it, how can i solve this problem, before all of them i asked whats that?
They said giant mups usually appear in motor noron ilness and sometimes appears hernia. But hernia problem is not so worst. I really visited alot of doctors and they said different different things and i m bored.

one of them said make emg test again later coz there is a giant mups and it looks dangerouse
other one said your problem coz of hernia.
i visited alot of doctors about hernia problem and they said your problem is not about us go to nerology doctor. Nerology doctor send me different one so i really bored and tired. If its Als let it be, what can i do? Just want answer from doctors and i couldnt find, so thats the reason why i am here and stolen your time. So sorry Nikki, if i disturbed you

 

[Dusty7]

When an anterior horn cell (motor neuron) or its axon is injured or dies for any reason, the muscle it used to innervate becomes denervated. The healthy axons around the now-denerated muscle will try to reinervate it, which means that that axon will innervate more muscle fibers and the MUP (motor unit potential) becomes larger than normal. Over time if this axon continues reinervating more and more denervated muscles, the MUP can become very large, or Giant. This process may take years.

In my understanding, this process proceeds whether the anterior horn cell or axon died due to a disease or a trauma. Therefore, there is no reason to associate Giant MUPs with ALS. They can well be the result of injury, as in injury to the lower back followed by years of denervation and reinervation.

 

[alex34]

thanks for the answer Dusty7.
So what should i do? my weakness is growing by day by. I dont feel so powerfull as 60 days ago. Dont want to use my lef leg and spending my time in the bed all day. Strange and weird feelings on my left leg. A kind of stifness and gives me weird pain.
Where should i go? Which department? They couldnt answer me logically and thats the reason why i am here.

 

[Dusty7]

Can't tell you what to do as I'm not a doctor and have no knowledge of Russian medical system. My knowledge is in ALS and I didn't want you to think you had ALS just because of a Giant mup.

Your first EMG which was completely clean tells me it's not ALS. Your second EMG apparently only showed a Giant mup. A giant mup is a sign of chronic denervation and reinnervation. So, neither EMG showed acute (current) denervation, nor did it show widespread denervation. That tells me it is not ALS which requires widespread, acute denervation and chronic reinnervation.

Sorry, I can't help you more.

 

[Nikki J]

Go back to your regular doctor and see what they think. But get out of bed! Even people with ALS move about as much as they can. Bedrest will make a back issue significantly worse and even healthy people lose strength while on bedrest. They did a study years ago with healthy University students and proved that they lost measurable strength with even one day of bedrest

 

[alex34]

i went to new doctor and he said in als there are some signs just like yours but signals and muscles are looking normal. he gaved me some medicines. Injection and two different pills. By the way i translated to English perfectly about my emg result. Here its

right and left peroneal nerve motor response amplitude and conduction velocity was normal .
right and left tibial nerve motor conduction velocity and response amplitude was normal as normal.
right and left sural nerve sensory response amplitude and conduction velocity was normal .
Needle EMG MUP chronic neurogenic potential in muscle L4-L5 segments examined in the study, polyphasic Giant motor s was observed.

Result: The conclusions reached with the diagnosis of radiculopathy . MUP chronic neurogenic potential in the studied muscles in L4 L5 segments were seen. The obtained results were evaluated in accordance with chronic radicular changes .