Bilateral Clonus and Hyperreflexia

[Laurie H.]

Are bilateral clonus and hyperreflexia signs of ALS?

[hopingforcure]

They are both signs of Upper Motor Neuron problems.

[Laurie H.]

You said that bilateral clonus and hyperreflexia are both signs of Upper Motor Neuron problems. I am not sure; is ALS an Upper Motor Neuron disease? Laurie H.

[BrianD]

To get a diagnosis of ALS, you need to show signs of both Upper and Lower Motor Neuron disease.

Clonus and relfexes are indications of Upper Motor only.

[Laurie H.]

Thank you. Can you please tell me what Lower Motor Neuron signs could be? Laurie H.

[Danijela]

From wikipedia: "Signs of lower motor neurone damage include weakness and muscle atrophy." From what I recall, reflexes are decreased with lower motor neuron damage. However, an atrophied muscle (lower motor neuron sign) with hyperreflex (upper motor neuron sign) is one of the hallmarks of ALS. Fasciculations (muscle twitches) are also considered a lower motor neuron sign.

[Laurie H.]

So if I have the following symptoms, would you suggest that I ask the doctor about ALS? I am seeing a neurologist, but he has not given me any possible reasons for my symptoms.
Laurie H.

Hyperreflexia
Bilateral clonus
Muscle twitches throughout body (wax and wane)
Tingling in feet and hands

[BrianD]

Laurie...

Well... you should probably discuss it with him since obviously you are concerned about ALS being an option. But I'm the type of guy that expects open dialogue with my doc. But a good doctor is not going to widely speculate possible diagnosis either... they will continue to collect more data.

There are a number of conditions that can cause the symptoms you list. The neuro will need to run additional test to give you an accurate diagnosis. This typically would include blood tests, and possibly an MRI, etc.


Brian

[Laurie H.]

In December, I noticed tingling in my hands and my feet. At about this time, I broke out in hives and had angioedema (swelling of lips and eyelids). Allergy testing revealed that they were both autoimmune in origin. My allergist said, "If I were your husband or you, I would be very concerned about an autoimmune issue." Not long after the hives and angioedema, I became extremely ill and was bedridden for a number of weeks. I was extremely weak and had difficulty holding up my head, raising my arms, getting out of bed. I lost over 10 pounds in less than 2 weeks. I also had difficulty breathing during this time, having episodes where my breathing actually stopped. I was fatigued, weak, and very nauseous. Also had trouble swallowing. After I began to get better, I began to experience muscle twitches throughout my body. My neurologist said that my MRI was normal, my EMG was "relatively normal." Nothing has showed so far in blood testing.

Can you tell me what tests neurologists typically do to rule out ALS? I want to know if the tests that I have had have ruled this out. My neurologist has not said anything about what his testing has ruled out.

Laurie H.

[hopingforcure]

Your emg sounds like good news. Did you have a MRI? or spinal tap? sound's like your doctor is thinking alond different lines and not als. You should get another opinion, and or make an appt. to sit down and talk with your neuro.

[Wynn]

Laurie
Did he test you for myesthenia gravis?
Wynn

[Laurie H.]

Wynn: No, I was not tested for M. Gravis. What are the symptoms of this? What tests would be run? Laurie

[Wynn]

This is a good link for myesthenia gravis:

Myasthenia gravis - MayoClinic.com