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New member
May 25, 2007
My wife just received a MRI report that showed atrophy of the motor cortex. The report states the findings are worrisome for ALS. The doctor giving her the news was visibly upset. We're now trying to get into an ALS clinic ASAP. She's in otherwise excellent shape but travels a lot on business, and for years has had problems with her back. Six months ago her right hand began to bother her, more recently her hands and feet go numb when she sits or puts her back in a certain position. She's also noticed getting weaker on the right side, this has been confirmed by her pysical therapist. No issues speaking, swallowing, dropping things, tripping, or cramps; although her big toe does bother her at times.

I've read as much as I can on ALS, and despite she doesn't have a number of the symptons, those she does have seem consistent with the disease. Does a MRI definitely diagnose ALS? Is there any anything else to hope for a cause of these types of symptoms? What comes next?
While I am new to this, I believe that an MRI is certainly not the basis of a definite diagnosis. The diagnosis is based on a combination of clinical and laboratory findings. The process for diagnosis may take a long time, although neuros with ALS expertise can apparently make a diagnosis fairly quickly. I will keep you and your wife in my prayers.
From the research I have done over the last year, along with my symptoms and workup, MRI is never the basis for a diagnosis of ALS. I'm sure someone on the forum will correct me if I am wrong, but I can't believe that doctor said that to you at all. Numbness is also not consistent with ALS.

The fact that you are going to an ALS Clinic is great news. They will give you definite answers to these concerns, but I think you should rest easy as far as als. There maybe something treatable going on, like MS or maybe something even more treatable than that. Did she have an MRI of her back. It is possible radiculopathy could cause these symptoms. I wish you both the best of luck and please keep us informed. Leslie
MRI's are usually given to rule out tumors, pinched nerves, ruptured discs and assorted other causes for leg or back pain. It's another tool used in the final diagnosis of ALS and I have never heard of a Neurologist basing a diagnosed on just this test.
Hi danj- I would like to offer you some room for hope. this time last year my local neurologists (2 of them, actually) plus my Pt and GP were all visibally upset and made an appointment for me to go to the ALS clinic. I asked each one of the local guys what there were afraid of and they said my symptoms were consistient with AS.

At home, we started making plans for remodeling the house, and so forth. Then in December I stopped develping new symptoms and the ones I have are stable. So I am used to living with certain weakness and have made adjustments where necessary but, for now, I am holding my own. The clinic is saying we need to wait and see. so I am still working, still driving, still traveling. I could live like this for the rest of my life, happily. Nothing would make me happier than having dodged the ALS bullet.

My clinic says there are rare cases where people start off with a bang and then don't progress. Perhaps your wife and I fall into that category.:) Here's hoping for a good visit at the clinic! Cindy
You should get to a specalist, it could be a number of things.

I have the big toes thing now. It could be what they call "long tract changes", which involves the babinski sign. did your dr. check her babinski sign? That is when he scratched the bottom of her foot with something sharp and her big toe will either go up or down.

MRI, is not a diagnosed tool, it's the evidence of upper and lower motor neuron damage.

How are her reflexes? are they hyperactive....? What about atrophy? Clonus?

please feel free to ask questions.


Thanks for the comments

It will be several weeks until we get to a doctor. What's most bothersome now, besides the worrying, is the numbness/pins and needles she feels in her limbs when she sits in a certain way, or has her neck bent in a certain way. We're not sure if that's a usual sypmton or not.
Did she have an MRI of her neck and back? Numbness, pins and needles are not usual symptoms of ALS I think you don't need to worry about als. Good luck. Leslie
Shes she did. The MRI of the brain says she has bilateral atrophy of the motor cortex with more severity on the right. It also says she has increased signal present along the corticospinal tracks.

They also said she has a herniated disc. Strange thing is the sensations are on the right side, yet the brain atrophy would indicate it should be on the left.
I am sure a good neuro at the clinic you're going to will be able to explain these findings to you. Hopefully her problems are coming from the herniated disc. I know when I was being evaluated for MS the docs said they were looking for increased signal along the spinal cord. I don't want to alarm you with that, but it is a far better diagnosis than als. I hope she gets answers soon and then treatment. Good luck. Leslie
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