Thanks for the replies. My attempt at brevity left some things confusing. When I saw my neurologist, I had no idea that my referring doctor thought I had a real problem. On the first visit to the neuro and after the muscle and nerve conduction tests and upon completion of my physical exam, I asked him "what's up?" His reply was, "You have a motor neuron disease, and I think you should sell your dental practice". I thought a few seconds, then I asked him, "you mean like als?" to which he replied that it would be the most common form, but it was possible I had MMN or some other rarer form of MND. He said he would recommend IVIG in case there was an autoimmune contribution to my situation (those blood tests turned out negative) and that my HMO does a lot of IVIG treatment, we would do two sessions, then reevaluate everything. He ordered all the other tests, MRI etc. at that time, and texted me when all the tests were done that we would continue on this IVIG tract until he was convinced it was not helping me. He did not do the Babinski test, later my primary care doc did it and I termed my response as "brisk" only because my primary doc remarked how strongly the toes on both feet responded positively with little stimulation. As far as some days being better than others, I would relate it more to what demands I am putting on my body. My neck, right arm/shoulder weakness and early fatigue are unchanged. By the way, I have no deltoids nor triceps muscles of significance, but my biceps are still visible. The hand muscles atrophied early on. What seems different is that the large muscle cramps in my calves are reduced to small cramps that can come and go, but not be debilitating. These cramps are like small muscle groups get hit for a minute or so, then relax. It happens mainly in my legs, intercostal (rib) and jaw area. Both sides are affected. Overall fatigue is still present and I notice the summer heat really takes a toll on my ability to function. If you will indulge me, I would like to relate an experience I had some 4 or 5 weeks ago. I woke up early in the morning to my left leg in total spasm, the whole leg, with the left foot painfully extended in a spastic fashion. My right foot, not the whole leg, at the same time, was also extended in a spastic fashion and I was unable to get out of bed, much less attempt to stand. After a few minutes, the muscles relaxed, but my left calf ached in one area for a week, and now I cannot flex my left foot to the extent I can my right foot, as though some muscle group no longer works. When I drive, after a couple of miles, my right ankle tightens up where it is difficult to move my foot. When walking, it feels like someone is squeezing the distal half of my foot. I have read about foot drop, and I wonder if these symptoms could be a precursor. I am a veteran, and have an appointment with the neurodegenerative clinic in late November at the San Diego VA center. They cooperate with UCSD and their als clinic, so I am in the process of getting a second opinion on my status. I sense that time will tell, one way or another and in my mind, if there is any doubt, I am willing to have the IVIG as long as my neuro is willing to have it administered. Again, I see him on Sept. 2, and have a growing list of questions for him. My primary questions on this forum were related to the Babinski sign, and whether MMN people interact on this forum. I thank you that those questions were answered. Steve
