Distinguishing Upper motor Neuron disorder from Lower

[olly]

michelle

iv'e no family history of hsp , also had genetic testing and everything ok,so in my case its sporadic.
the difference between hsp and pls is that in pls symptoms/signs are more progressive and in upper body and bulbar rather than just in legs/lower body as in hsp.

 

[MICHELLE40f]

olly,I have some slurred speech and some minor arm weakness,and "minor swallowing" problems at night..wake up feeling like i am choking on spit? i guess,anyway i told my neuro of this and he says that is part of my disease....so i get very confused about my diagnoses,although the spastic paraplegia website does say that some people get swallowing problems and slurred speech arm symptoms etc with it too?

rate of progression can also vary,some people with hsp have as fast a progression as with pls,others have very slow progression in either case,so it does get confusing.

 

[olly]

michelle

have you seen articles at emedicine
hsp------http://www.emedecine.com/pmr/topic45.htm
pls-------http://www.emedecine.com/neuro/topic324.htm
there is complicated hsp that can effect swallowing ect ,but its usually hereditory and not sporadic.
sporadic sp with upper body /bulbar symptoms is pls, though some neuro's get them mixed up but progression will destinguish which one.
if your not happy with your diagnosed get a second opinion.
hope that helps a bit.
caroline

 

[olly]

hsp/pls?

In most forms of HSP, the condition primarily affects the lower body. However, rare forms of the disease can also have upper body or additional neurological symptoms. In PLS, the arms, speech and swallowing are generally affected as well. Symptoms typically start in the lower body, although they can begin in the upper body, first.

Predominant features
hsp
Insidious, progressive spasticity and weakness of the legs that often gets severe, requiring assistive devices. There is also difficulty with balance, clumsiness, and often muscle spasms.
pls
Progressive spasticity and weakness of the legs that often gets severe, requiring assistive devices. There may be muscle spasms. Weakness and spasticity in the arms and hands also occurs, as well as in the bulbar muscles, causing slurred speech and difficulty swallowing. Sometimes, symptoms begin in the upper body first.

Secondary features
hsp
Urinary urgency and frequency is common and high arched feet are often present. Very rare types can present speech problems, ataxia, mental retardation, dementia, visual or hearing dysfunctions, extrapyramidal dysfunctions, adrenal insufficiency, or ichthyosis. While the arms are not generally affected enough to produce symptoms, some patients report minor spasticity and weakness in the arms.
pls
None
from spf foundation

 

[MICHELLE40f]

thanks

yes i have read all of those sites on hsp/pls, tis why i get so confused when my neuro tells me all my symptoms are from "my disease" hsp seems i have symptoms that could be either hsp or pls....only thing is i have a very slow progression for pls,then again on the pls data base alot of people have slower progression,,,,,,,,ugh who knows? LOL thanks again

 

[Geo]

This is why we need our Doctors to be on top of things so they can differentiate between the different ones or know to run the necessary tests . When we have health care people that dont stay on top in their field the patient suffers .Just like in my ex profession we had people who just sat back and road the gravy train
Well the state finally stepped in and said we are going to have Continuing Education in all Licensed fields ,that means you must complete a field related class in order to renew your license every year .This means you will stay on top or you wont have a job .No more Gravy train Geo

 

[Geo]

Michelle when you say Choking on spit . This is due to the muscle in the orapharyngeal area and the neck and throat constrict or tighten and close in on eachother making them come together and touch . Look at your throat and neck as a pipe .If that pipe constricts on itself it makes it feel like your choking or gagging on spit .Clearing your throat alot will help some ,take a drink of water, just a little ,sleep on your side rather than on the back . On cold nights i use a heating pad under my back ,kind of relaxes the muscles . Hope this helps Geo

 

[MICHELLE40f]

thanks a lot geo! i never knew that about the choking!:mrgreen:

 

[Geo]

Your welcome . Have you ever noticed having problems swallowing your pills or swallowing large pieces of food .This is because those muscles i mentioned are constricted or tight . Takes alot of muscles to swallow
we dont realize this until we have a disease like ours lots of complex things going on . My big problem is cold liquids ,i learned to move everything to the left side and it goes down alot better Geo