What other conditions mimic early ALS?

[AndyDJX]

I know that many have been diagnosed with ALS because every other possibility had been exhausted. What other things do doctors look for that could be causing ALSish symptoms? I know that ALS ultimately is not a subtle disease to say the least, but it is in the beginning it can be.

I started twitching 2.5 years ago and show minor (possible) atrophy in my right thenar thumb muscle and inner left foot. I also show intense muscle fatigue after exertion and catch my foot quite often (but don't trip.) My right hand is stiff in the morning and I often wake up with the ulnar nerve on one or both hands causing my pinkie or ring finger to be asleep/paralyzed. My right thenar and hypothenar have been facisculating like crazy lately. But I've also have other symptoms such as flickering vision, tingling, sore spots, etc. And I've had 2 clean EMGs and doctors saying they don't think it's ALS.

What else could it be? What causes fasciculations, weakness, fatigue, cramps, stiffness, minor atrophy, etc? I've heard of:

CIDP
Lyme Disease
Kennedy's Disease
some cancers/paraneoplastic syndromes
radiation damage
spinal muscular atrophy
benign fasciculation cramp syndrome

I know there are many people on this site who are undiagnosed and looking for answers. I think ALS is a relatively well known condition; I've recently seen two features on television that discussed it. Because of this, Google University tends to suggest ALS but many of the individuals who come here should be investigating other possibilities with their doctors. What are some of the other ones?

Thanks,

Andy

[AndyDJX]

Does anyone have any ideas?

[Everlast]

anxiety? that s all that docs say to me

cipro or levatin fluroquinilones medicaments..

[codya13105]

Originally Posted by Everlast

anxiety? that s all that docs say to me

cipro or levatin fluroquinilones medicaments..

did you have an issue with cipro as well??

[AndyDJX]

Anxiety is a good one, because it can cause twitches, speaking problems, breathing problems, etc. But at a certain point I think anxiety can be ruled out as well (for example, anxiety can't cause atrophy)

[Zaphoon]

Andy,

The list of things would be huge! Throw MS and all of its variants into the mix, a whole host of neuropathies (too numerous to mention) and then try a disease soup. The soup would/could consist of multiple things attacking the body at one time. One thing might be causing one symptom and another syndrome/disorder/disease could be causing another.

Rule-outs can take a very long time for that reason. The more symptoms you have, the longer it may take to explain the cause(s).

Zaphoon

[crystalkk]

Lyme disease
all kinds of myopathies (muscle diseases)
autoimmune diseases

there are so many

[Everlast]

Originally Posted by codya13105

did you have an issue with cipro as well??

I dont know i just know i took 3 boxes of cipro before all my story

[AndyDJX]

Zaphoon and Crystal--

This is reassuring. I think for many, myself included, I've said "fasics, atrophy, weakness, it HAS to be als!" even when doctors have said that it's not. I thought it would be good to compile a list for those who are in the "is this...?" boat who come to this site, so they know they should be investigating things with their doctors outside of the realm of MND.

I'm glad there is this section of the board for those of us who have questions and concerns, so I don't feel like I'm crashing the boards even though I may not belong here. Though honestly, my mind is only half convinced. My thenar muscle twitched for months straight and then a huge ridge showed up, now my hypothenar is twitching all day and my hand gets super weak after exertion. I want to demand answers from doctors, but they just don't have them. I guess their attitude is "if it's ALS, we'll know in due time," which can be hard to accept. I think it also makes many of think "well, I have it, they just haven't diagnosed in yet" when in reality we may have something much less insidious.

[Zaphoon]

Andy,

You make some good points regarding attitudes some doctors have. I've come to conclude that the science of neurology is very, very complex and some diseases have so many mimics that sometimes, things have to become blatantly obvious before some doctors are willing to make a diagnosis.

My differential from one doctor is PLS to which a second disagrees and tells me to eat more bananas, drink more water and do stretching exercises.

To the first doctor, my symptoms are bad enough for at least a ddx of something while to the second, my problems are minor enough to be fixed by a banana.

One doc says, "See you in 3 months." The other says, "I can see you again in 6, if you want (meaning he really doesn't care if he sees me or not)."

So, in the meantime, I follow the docs advice regarding bananas, water and stretching and wait to see if it cures my hyperreflexia, cramping and spasticity and see the 1st doc in 3 months.

What is suspected to one doctor can be nonsense to another.

The good news for me is, one doctor clears of PLS and I happen to love bananas. More water and exercise can do no harm. Yippee!

[aobrien]

Andy DJX -
Have you read stories from other people who used cipro? I suggest you do, I think you will find several of your symptoms are shared by patients who have used this drug.

I was diagnosed by my GP with "likely an espisode of GBS". But, I had zero symptoms before Cipro.

[crystalkk]

Andy,

One thing that I did learn by going on other forums and actually talking to people that have been dxed with other diseases that can mimic ALS is not everyone presents with the text book version.

Many of theses diseases can take a couple of years to be dxed also.