Tingling - an ALS symptom?

[danita]

My brother, age 67, has been experiencing progessive tingling and muscle weakness in the index and little fingers of his left hand. When he lays his hand palm down he cannot lift those two fingers. He has been seeing doctors, had an MRI, more are ordered but no one has given him any specific diagnosis yet. He peeked at the papers he was given to take with him to the next MRI and saw "possible MND - atypical". Looking that up online he found MND & ALS mentioned together. Needless to say he is very worried.
I have been doing a lot of searching online and I've yet to find "tingling" as an early symptom of ALS. My brother has Type 2 Diabetes (takes medication but doesn't need insulin yet) and I'm inclined to think that the symptoms are related to that. Does anyone have any information or experience that might shed some light on these symptoms and their possible link to MND or ALS?
Thanks for your time.

[rcharlton]

From what I know - tingling is not a typical symptom of ALS. ALS is a motor neuron disease. The motor neurons degenerate and our muscles start to lose contact with the brain. When this first starts to happen, the muscles start involuntarily twitching. The motor neurons instruct the muscles when to move and when not to move - so when this pathway breaks down - the muscles start twitching on their own. Thereafter, as our muscles are left stranded without any stimulus from the brain via motor neurons, we experience reduced coordination, weakness and muscle wasting - not lack of feeling, nor numbness, nor tingling or other sensory aspects. I don't think there has been any established correlation between amount of twitching and muscle atrophy - it's different with everyone.

I don't think that ALS typically causes any direct sensory impact - only indirect - cramping in hands due to weakness, soreness in parts of the body due to lack of mobility - but no direct pain or other sensations.

At the diagnosis stage, patients suspected of having ALS are usually asked if they experience any numbness or tingling - as these symptoms are not typical of ALS and my suggest some other ailment.

You should note that there is no "typical" ALS case - symptoms present differently in everyone. I did experience numbness in my chin for a while - which is unusual.

I hate to throw this out there - but numbness and tingling sensations are fairly common symptoms of Lyme disease - which often mimicks other ALS symptoms - so you may want to look into this.

Good luck.

Richard

[ladave]

Originally Posted by rcharlton

From what I know - tingling is not a typical symptom of ALS. ALS is a motor neuron disease. The motor neurons degenerate and our muscles start to lose contact with the brain. When this first starts to happen, the muscles start involuntarily twitching. The motor neurons instruct the muscles when to move and when not to move - so when this pathway breaks down - the muscles start twitching on their own. Thereafter, as our muscles are left stranded without any stimulus from the brain via motor neurons, we experience reduced coordination, weakness and muscle wasting - not lack of feeling, nor numbness, nor tingling or other sensory aspects. I don't think there has been any established correlation between amount of twitching and muscle atrophy - it's different with everyone.

Richard

Richard-

An incise description. Is there really no established correlation between twitching and atrophy? I had assumed that the muscles began to atrophy as soon as the neurons connecting them to the brain degenerated. And yet Al has posted to me that he can still walk three years after his fasciculations began. Is my understanding of this fundamentally wrong? Are there any theories as to how long a muscle can survive, and more importantly how we can help it survive, when nerve degeneration is underway? Or does fasciculation happen with less neuron damage than is required for atrophy to occur?

Dave