Old 10-07-2008, 05:58 PM #1 (permalink)
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Question What are the symptoms of ALS?

I’ve been reading through a bunch of posts trying to peace together the symptoms and their progression. I understand that they very somewhat. Can anyone layout a typical list of findings as they would occur in an ALS patient.

Here’s a possible format for the layout order that I’m looking for. Please correct and add anything to this list, IM SURE THERE ARE MANY THINGS WRONG WITH THIS LIST.

Twitches – Initial sing/early stages
Weakness – Initial sign/early stages (Usually 6 months after twitches)
Spasms – Early Stages (Usually 6 months after weakness has started)
Atrophy – Mid/late stages (Usually 1-6 months after spasms)
Clonus – Initial Sign/early stages/mid and late (always present in all patients even before initial sings)
Babbinski’s sign - Initial Sign/early stages/mid and late (can be present even before initial sings)
Hyper reflexes - Initial Sign/early stages/mid and late (always present in all patients even before initial sings)
Speaking troubles - Initial Sign/early stages/mid and late
Swallowing issues – Mid to late
Breathing issues – Late stages
EMG findings – Mid to late stages
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Old 10-07-2008, 06:23 PM #2 (permalink)
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Some of the stuff I have been reading suggests that breathing can be an early issue or a late issue. Also, it seems that usually twitches will come after weakness. Wouldnt atrophy come before weakness since it is what causes weakness? Just some food for thought.

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Old 10-07-2008, 06:31 PM #3 (permalink)
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Nothing you have stated is really correct. There is no way you can say any one of those symptoms are early or late. It all depends on lower motor neuron death and upper motor neuron death and when they happen . . . where they happen . . . if they happen.

There are variants of ALS where the upper motor neurons are spared or the lower motor neurons are spared.

The EMG's are useful only when the lower motor neurons are affected. You state that the EMG is useful in mid to late stages of ALS: where did you read that? EMG's can detect subclinical symptoms when you have no clue you have ALS.

Muscle atrophy after 1 to 6 months of spasms is something I've never heard of . . . where on earth did you read that?

I really don't think it's worth continuing this response.

Please STOP trying to self-diagnose yourself. Go to a good neuro . . . preferably at an academic institution and let him/her give you the answers you need.
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Old 10-07-2008, 06:33 PM #4 (permalink)
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See the post below (I hit the send button too soon)
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Old 10-07-2008, 06:38 PM #5 (permalink)
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CB1977

No, weakness precedes muscle atrophy in ALS.

Weakness is caused by denervation as is muscle atrophy but the weakness will occur immediately after the denervation and the muscle atrophy will follow. There will be a point in time when both will progress more or less evenly.
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Old 10-07-2008, 06:39 PM #6 (permalink)
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Wright- So what your saying is that you would feel the weakness and then later see the atrophy? I am just wondering because I am having some issues with my arm and this might give me some perspective. I was assuming that weakness would be a result of the atrophy. Would atrophy show up on an MRI?

CB in Ohio
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Old 10-07-2008, 06:50 PM #7 (permalink)
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I really don't think it's worth continuing this response.

Please STOP trying to self-diagnose yourself. Go to a good neuro . . . preferably at an academic institution and let him/her give you the answers you need.[/QUOTE]


I guess if we all listened to this guy then there would be no forum, but I say this forum has been very encouraging. Thanks to everyone for their posts and reply’s and for not being impatient with us who are really seeking answers.
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Old 10-07-2008, 06:52 PM #8 (permalink)
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Default Wright

Is there a list of ALS symptoms on this board anywhere? Maybe if you posted a thread with the right symptoms, it might help clear up what is, and is not ALS. If you don't think it would scare anyone. Just a thought. I'd like to know more myself .
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Old 10-07-2008, 06:58 PM #9 (permalink)
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Default my two cents (yes, haha, for all it's worth)

As a newcomer, I actually find Wright pretty entertaining and knowledgeable at the same time but I agree with L4ddybugg, I would love to see a lot of information in one place and Wright seems to be a good one for the task.
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Old 10-07-2008, 07:11 PM #10 (permalink)
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jason@goodmeasurellc.com

I'm not being impatient. You had a string of symptoms that are all attributed to ALS but you simply can't put a timeline on them because of the variability of the disease.

If you have specific questions, then I would be more than happy to help you. I'm here trying to get you to stop with your internet searches, because they are obviously driving your anxiety levels through the roof.

Make an appointment with a neuro because they're the ones who are going to ultimately help you. Again, if you have specific questions, then ask.
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Old 10-07-2008, 07:20 PM #11 (permalink)
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CB1977

Again, if you notice the weakness initially, muscle atrophy will be seen later. Sometimes people don't notice their weakness initially, especially with ALS, because it's such an insidious disease.

Muscle atrophy can be seen on an MRI if it is specifically investigated. It is highly unlikely that any physician is going to give you an MRI to look for weakness, though . . . and even if they wanted . . . it's my bet, that would be a hard one to sell to an insurance company. Muscle atrophy can simply be visualized or measured.
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Old 10-07-2008, 07:29 PM #12 (permalink)
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Thanks wright, that certainly helps.
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Old 10-08-2008, 12:22 AM #13 (permalink)
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Geo. Washington U in St. Louis has a good neuro site with all the symptoms of the various MND's for those that require more than is found here or on the ALSA site. By the way, if anybody doesn't like the answers they get here, there are other sites available.

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Old 10-08-2008, 12:41 AM #14 (permalink)
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Default The Other Possibilities

One of the things I've really benefitted from on this forum are those that have shared about the many, many, many other possibilities outside of ALS that could be causing their symptoms.

I'd like to encourage people to examine other muscular/neurological disorders before fixating on ALS as a probable cause for their condition. A treatable neuropathy is much more to be desired than an untreatable NMD.

I am guilty of trying to self-diagnose in the past (yep, went to those sites we've all been to that list symptoms common in ALS and I convinced myself I had most of them) and am glad to say I've now left it up to the MD's to figure out my case.

For those still without a DX, why not try focusing on the myriad of other possibilities?

Good luck!

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Old 10-08-2008, 07:35 AM #15 (permalink)
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Quote:
Originally Posted by Zaphoon View Post
One of the things I've really benefitted from on this forum are those that have shared about the many, many, many other possibilities outside of ALS that could be causing their symptoms.

I'd like to encourage people to examine other muscular/neurological disorders before fixating on ALS as a probable cause for their condition. A treatable neuropathy is much more to be desired than an untreatable NMD.

I am guilty of trying to self-diagnose in the past (yep, went to those sites we've all been to that list symptoms common in ALS and I convinced myself I had most of them) and am glad to say I've now left it up to the MD's to figure out my case.

For those still without a DX, why not try focusing on the myriad of other possibilities?

Good luck!

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Don’t beat yourself up for taking charge of your health. Your probably much smarter than some self-serving egotists would like you to believe.
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