ALS Symptoms?

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wsmbm

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Hello all. Hope everyone is well and thank you for taking the time to read my post. I wonder if anyone could give me an idea what they think of my likely issue please –

Symptoms - 47y/o male. Front left-thigh muscle weakness for 12 months. Around January I started to notice 24hr widespread fasciculations all over my body. (In my arms and legs I can stop these temporarily by tensing the muscle). These are still largely my only symptoms today although I had uncontrollable hand and feet jerks whilst sleeping for about a month (now stopped). Walking is harder but no obvious atrophy or spasticity anywhere. Previous history of short-term severe lower-back pain approx 3 years ago.

Local Doctor (Feb) - examined me and tested my reflexes: all fine apart from my left knee which had absent reflexes. He said he did not know what was wrong and only noticed one leg being weaker than the other, but he referred me to Neurology and ordered an MRI.

Neurology Exam (Jun) – all fine apart from left thigh weakness. He said it was only weak in one direction. No Babinski sign etc. I can still stand on my heels (easy) and my toes (just). No obvious problems with upper body. He said he was “more than 50% sure it was back-related, but he’d send me for an EMG anyway.

MRI results (Jul) - show ‘nerve-displacement’ in lumbar area which would weaken the affected thigh. Although this would not explain the fasciculations (and I have no back-pain whatsoever) my local doctor said he was convinced this was the source of all my problems, but I should go for the EMG anyway.

EMG/NCG (Aug) - the operator said it had picked up weakness in left hand and right arm (of which I was unaware despite ongoing fasciculations in those areas). I don't notice any issues in day-to-day life. These problems could not be explained by the earlier problem discovered on the MRI scan. He said he could not give me a certain diagnosis, but said he “could not rule out Motor Neurone Disease”. The EMG was very thorough, and he tested all limbs and my lower back. I don't have the EMG results.

I have now to go for a full spinal MRI which was apparently booked in as 'urgent'. Is this starting to look like ALS/MND? With it starting in my quads and progressing slowly, I was also suspicious of Inclusion Body Myositis (IBM) but I am not sure if fasiculations come along with that? Thank you very much for any help / input.
 

Clearwater AL

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WSMBM, your situation seems unique even though it looks just like many of the
Neurological case studies found on the internet. Maybe review some of them
which often give a conclusion which could be helpful to you.

But, once again as we have told so many... to address your issues it will be very
helpful to us if you post your EMG results/findings with summary/conclusion.

Until then....
 
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affected

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We don't diagnose people here. You sure aren't describing ALS. Maybe you need to go discuss your results with your doctor? I do wish you all the best.

Try reading here too as it is our official position.
 

wsmbm

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Thank you both very much for your advice and replies.
 

lgelb

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Your EMG could be helpful if you'd like to obtain (as you surely have the right) and post it. It's not "weakness" per se that's picked up by an EMG -- it's changes in the nerves and muscles that can point many different directions, depending on what the changes are and the rest of the story, that the EMG doesn't write, like what you can do.

Best,
Laurie
 
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