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  • Difficult to answer simply because the neurologic community does not agree on a definition of ALS. I would say that the current belief is that ALS covers the whole spectrum of MND (motor neuron diseases) from PLS (UMN only) to classical ALS (UMN & LMN) to PMA (LMN only). If you believe in the classical definition, then a clean clinical exam, which would rule out UMN, would also rule out classical ALS. If you believe in the current (whole spectrum of MND) definition, then a clean clinical exam does not rule out ALS of the PMA (progressive muscular atrophy) variety.

    The spectrum definition is based on the belief and clinical findings that many or most people with PMA will eventually develop UMN signs and then will meet the classical definition of ALS. So, along this line of thought, a clean clinical exam would not rule out PMA which is merely a way station on the way to a dirty clinical exam and full blown ALS.

    Got it?
    ALS is a disease of widespread acute and chronic denervation.

    No, it does not start in all places at once, but it is a progressive disease. So it typically starts in one limb, say, a leg, then progresses to the other leg, then to one arm, then finally the other. The pattern is usually distal--starting farthest from the body core and progressing toward the core. It does not have to wait to get to the core before it moves to another limb. The rate and pattern of progression vary from person to person.

    Not really covered in the Sticky, so not a stupid question...
    Eu vi sua história e me identifiquei bastante. Dia 16 agora eu vou no Sarah pra uma consulta, espero que eu traga notícias boas. Assim que eu obter algum resultado te mando uma mensagem. (Eu também sou hipocondriaco, tendo a achar que estava com linfoma, neuroblastoma, melanoma e outras doenças fatais) Mesmo sabendo desses dados, e que é muito raro uma pessoa nessa faixa de idade possuir a doença, sei que é possível e meus sintomas estão me matando.

    No mais, boa sorte!
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