Old 05-01-2009, 04:39 AM #1 (permalink)
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Default pleas tell me how difrential diagnosed ALS by drug induced ALS symptom

HELLO
i am a new member . my father have 67 years and from 3 months ago he began with muscle atrophy in left food. after any screening by neurologist (MRI ,CBC, Pb blood level , ESR,T3/T4,LDH,SGOT,SGPT, Na-P-Ca, HTC,.........) all tests is ok except EMG that reveals muscle atrophy in left food and any other hand and food have not any signe in EMG. His neurologist diagnosed "probable ALS " and said that if symtomes become sever take EMG in 2months later . because he take the Levostatin ( drug for controling cholestrol )for 10 years and this drug may mimic ALS symptums do we have a chance the symptom is due to drug? (notice that the CPK is high CPK =360)
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Old 05-01-2009, 09:21 PM #2 (permalink)
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There are alot of other things that can cause foot drop.

How was his sed rate? Did they test his ANCA blood level for vasculitis.

How was his clinic exam? reflexes, etc.,
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Old 05-12-2009, 11:12 AM #3 (permalink)
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Default does he realy has ALS

Patient history :
Sexuality :male
Age :68

Cardiovascular disease : he has history of Cardiovascular disease and he has the history of Bypass (1999 ).

Thyroid disorder : he has a history of hyper thyroidism (1985 ) and he have gotten radioactive Iodine and after that he has hypothyroid dysfunction and he gets L-thyroxin ( 100 μg per day ).

Blood pressure : after bypass surgery ( 1999) he had hypertension or unstable blood pressure ( 13/7,15/10 , 17/12 ) and since that time he gets Enalapril ( 5mg per day ).

Medication :
He got these medication at the time that symptoms appeared.

1- L- THYROXIN (100 μg per day ) since 1985
2- GABAPENTIN (100 mg per day ) since 2006
3- ASPIRIN ( 81 mg per day ) since 1999
4- ENALAPRIL ( 5mg per day ) since 1999.
5- NITROGLYCERIN ( 6.4 mg per day ) since 1999
6- FOLIC ACID ( 2mg per day ) since 2004
7- Vitamin B1 ( 300 mg per day ) since 1999
8- APO – ALPRAZ ( 0.5 mg per day ) since 1999
9-RANITIDINE ( 300 mg per day ) since 2001
10- CLIDINIUM-C ( 3 Tablet per day ) since 2001
11- BUSPIRONE (15 mg per day ) since 2006
12- FLUVAXAMINE ( 100 mg per day ) since 2003
13- ATROVASTATIN or LEVOSTATIN ( 20 mg per day ) since 1999
14- GINCOSAN ( 120 mg per day ) since 2003 and now for recent 6-7 months is replaced by GINKGOMAX (80 mg per day )
15-Vitamin E ( 400 mg ,3 times a week ) since 2003
16-Centrum silver ( 1 Tablet per day ) since 2003
17- Calcium –D ( 1 Tablet per day ) since 2000
18- OMEGA -3 ( 1 Tablet per day ) since 2000
19- C0-Q 10 PLUS ( 1 Tablet per day ) since 5 months ago



At the time that symptoms appeared ( 4 months ago ) he felt only heaviness in the left leg and went to the neurologist . she advised to take MRI ( Brain and vertebrae) and she said there was nothing and advised physiotherapy .
2 months later with elevation of symptoms ( more food drop / more falling / muscle atrophy) he went to the neurosurgeon and he ordered EMG ( only from left leg ) when the doctor saw EMG result and after physical examination he said that there wasn’t any problem in vertebrae and he suspected in peripheral neuropathy .
He referred the patient to the specialist in this field .
The next neurologist took another EMG ( from 4 bulbar regions ) and ordered many blood tests . After these tests and EMG her diagnosis was : MND (?) she advised these medications :
1- RELUTEK ( 50 mg per day ) for one week and after that 100mg per day
2- EFEXOR ( 75 mg per day )
3- L- Carnetin ( 500 mg per day )

She eliminated ATROVASTATIN and FLUVAXAMINE and BUSPIRONE .
She said that next visit should be 2months later.

Because the fatal nature of this disease and probability to misdiagnosis ,we consult with three more neurologist and every one got a new EMG . Upon to these consultation the first one confirmed MND in 4 bulbar region . The second one denied any symptoms of MND. Finally the last one got EMG ( from masseter muscle ,sternoclydomastoid , deltoid muscle , …..) and after that he confirmed diffused ALS and he said that the next visit should be 3-6 months later .



please help me about him
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Old 05-12-2009, 11:19 AM #4 (permalink)
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Default Does he have realy als?

Sexuality :male
Age :68

Cardiovascular disease : he has history of Cardiovascular disease and he has the history of Bypass (1999 ).

Thyroid disorder : he has a history of hyper thyroidism (1985 ) and he have gotten radioactive Iodine and after that he has hypothyroid dysfunction and he gets L-thyroxin ( 100 μg per day ).

Blood pressure : after bypass surgery ( 1999) he had hypertension or unstable blood pressure ( 13/7,15/10 , 17/12 ) and since that time he gets Enalapril ( 5mg per day ).

Medication :
He got these medication at the time that symptoms appeared.

1- L- THYROXIN (100 μg per day ) since 1985
2- GABAPENTIN (100 mg per day ) since 2006
3- ASPIRIN ( 81 mg per day ) since 1999
4- ENALAPRIL ( 5mg per day ) since 1999.
5- NITROGLYCERIN ( 6.4 mg per day ) since 1999
6- FOLIC ACID ( 2mg per day ) since 2004
7- Vitamin B1 ( 300 mg per day ) since 1999
8- APO – ALPRAZ ( 0.5 mg per day ) since 1999
9-RANITIDINE ( 300 mg per day ) since 2001
10- CLIDINIUM-C ( 3 Tablet per day ) since 2001
11- BUSPIRONE (15 mg per day ) since 2006
12- FLUVAXAMINE ( 100 mg per day ) since 2003
13- ATROVASTATIN or LEVOSTATIN ( 20 mg per day ) since 1999
14- GINCOSAN ( 120 mg per day ) since 2003 and now for recent 6-7 months is replaced by GINKGOMAX (80 mg per day )
15-Vitamin E ( 400 mg ,3 times a week ) since 2003
16-Centrum silver ( 1 Tablet per day ) since 2003
17- Calcium –D ( 1 Tablet per day ) since 2000
18- OMEGA -3 ( 1 Tablet per day ) since 2000
19- C0-Q 10 PLUS ( 1 Tablet per day ) since 5 months ago



At the time that symptoms appeared ( 4 months ago ) he felt only heaviness in the left leg and went to the neurologist . she advised to take MRI ( Brain and vertebrae) and she said there was nothing and advised physiotherapy .
2 months later with elevation of symptoms ( more food drop / more falling / muscle atrophy) he went to the neurosurgeon and he ordered EMG ( only from left leg ) when the doctor saw EMG result and after physical examination he said that there wasn’t any problem in vertebrae and he suspected in peripheral neuropathy .
He referred the patient to the specialist in this field .
The next neurologist took another EMG ( from 4 bulbar regions ) and ordered many blood tests . After these tests and EMG her diagnosis was : MND (?) she advised these medications :
1- RELUTEK ( 50 mg per day ) for one week and after that 100mg per day
2- EFEXOR ( 75 mg per day )
3- L- Carnetin ( 500 mg per day )

She eliminated ATROVASTATIN and FLUVAXAMINE and BUSPIRONE .
She said that next visit should be 2months later.

Because the fatal nature of this disease and probability to misdiagnosis ,we consult with three more neurologist and every one got a new EMG . Upon to these consultation the first one confirmed MND in 4 bulbar region . The second one denied any symptoms of MND. Finally the last one got EMG ( from masseter muscle ,sternoclydomastoid , deltoid muscle , …..) and after that he confirmed diffused ALS and he said that the next visit should be 3-6 months later .

14 DAYS AFTER ELIMINATION OF STATIN AND 5 DAYS AFTER USING RELUTEK THE SYMPTOMS GOES BETTER
WITH THIS NEWS IS IT REALY HAS ALS ?
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Old 05-12-2009, 11:46 AM #5 (permalink)
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Hello. I see you are understandably quite anxious about your dad's diagnosis. But this same message has been repeated in several threads, which some users may find off putting or confusing. I don't think that anyone on this board has a medical expertise to answer your questions but I am sure they can provide some personal insights or share their own diagnostic experiences. You seem to have saught several opinions, and the consensus seems to be to come back for further testing.

Waiting can be frustrating, but often with suspected or probable MND the doctors need to monitor and see how and if symptoms progress.
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Old 05-12-2009, 11:48 AM #6 (permalink)
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hello.
your dads health problems are very complexed and i dont think anyone here would be qualified to give you any specific advice.
you can not however rely only on the emg for diagnosed,there could be so many other reasons for the atrophy.
how are his reflexes? hyper?
did they note weakness?
you may just have to wait and see what the next test results reveal.

ps. you have so many threads going on its hard to keep up lol.
i noticed your dad was on statins,these can cause a host of neurological symptoms.
the fact he got a little better after coming off them two weeks is hopefull,tell the neuro at your next visit.

Last edited by olly : 05-12-2009 at 11:53 AM Reason: added something
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Old 12-09-2010, 01:32 AM #7 (permalink)
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Default Re: pleas tell me how difrential diagnosed ALS by drug induced ALS symptom

Approximately 70% of all carbon dioxide is carried in the blood stream using the acid buffering system of bicarbonate and hydrogen ions. This system allows a large amount of carbon dioxide to be transported with fairly small increases in blood pH or acidity. However, as the concentration of hydrogen ions continues to increase the buffering capacity of the bicarbonate system is reached.
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