could it still be something else?

[bart1]

I don't try to get my hopes up after being told mnd is suspected, but could it still be something else?

- Left shoulder in extreme pain for 2 months with constant localized fine twitching in left upper back (I guess this is related), with slight weakness. Echo shoulder was clean.
- Widespread twitching for 2 years (started in calves).
Could widespread twitching been bfs and localized twitching with shoulder pain have been the onset?

(don't know about emg results but clinical abnormalities: few beats of clonus, hoffman and brisk reflexes)

Wasting my time to hope it is something else?

[planningguy]

Hi Bart,

I read your other recent thread, and it would seem to me that the EMG findings thus far would be critical. Wright offered to review them if you could get the raw data, and I would certainly take him up on it.

If your EMGs have been thorough, and did not show any abnormalities outside of the shoulder area where you are having trouble, then I would say it is premature to say it is most likely mnd. I say that with the eternal caveat that I am not a doctor.

Best of luck,

Robert

[wright]

Yes, it most certainly can be something else.

The twitching in the calves has stayed just that . . . twitching with no weakness. That is the definition of BFS.

The pain in the shoulder area can be a gazillion different things. For example: my guess is that you're in front of your computer all day, either working or frantically researching ALS on the internet. This doesn't do your posture any good and can certainly cause shoulder problems. The twitching and "abnormal" EMG (I'm still waiting for you to post the results) in that area could be an irritated nerve due to your above problems. As Robert just said, if that is the only place there were any abnormalities . . . or if that is the only place your neuro EMG'd you, then it is MUCH too premature to speculate about your condition.

Furthermore, a few beats of clonus is considered normal. Once it gets beyond 5, it is considered patholophysiolgical. Hyper-reflexes and Hoffman (especially if they are symmetrically found on both sides of the body) can be due to anxiety or just simply the way you are.

Listen Bart, we know you're frightened but bottom line: you have not been diagnosed with a single thing. Your attitude should be . . . "prove to me that I have ALS" . . . instead of . . . "prove to me that I don't have ALS."

I wish you peace.