How Can They Tell The Difference?

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Active member
Jul 6, 2007
New England
I've had neuro. problems for years off and on. My mom just died from a fall that broke her hip but had ALS. Hers was upper.

While she was about six months into it I started having walking problems worse than ever before.

I just had an emg and he said ALS but it's in the lower parts. Could be years he told my husband.

Meantime I'm so depressed I cannot eat or look at food. So tired.

It occurs to me that when I mentioned sister diseases he just kept saying ALS.

How do they know the difference?

I do have a dropped toe and weakness in legs. I am just wondering if he is correct.

I have parathesias and myokymia if the eyes as well.

How can they tell a motor neuropathy from what you here have or ALS? Anybody know?
Your reflexes are brisk in als, in nueropathy they are reduced or absent.

So when you mention sister diseases, they would either be pure upper moter nuerons (PLS)
or pure lower motor nuerons, (PMA)

Lower motor nuerons show on an emg.
Upper motor nuerons are brisk reflexes, clonus, babinski, etc.
I forgot to ask you, did they do other tests as well to rule everything else out
MRI"S, spinal tap, bloodwork, ect.
Crystal I wanted to ask you about what you mentioned that LMN show on emg and clonus and brisk reflexes show upper motor neuron involvement does this mean because I have clonus and brisk reflexes that it will most likely not show on an emg?Mya

In ALS The emg will show the LMN stuff if you are losing muscle do to the nerves -denervation.
The brisk reflexes and clonus do not show on an emg they come from UMN which comes from the
brain stem.

EMG's also show alot of other problems, muscle disease, nueropathy, ect.
Your reflexes are brisk in als, in nueropathy they are reduced or absent.

Would you still have a reflex if your muscle was completely wasted and you had no strength or movement? I don't think above is entirely true, is it?

From what I understand, even if you had no strength or movement your reflexes will still be brisk
if your upper motor nuerons are damaged. I can only go by my research, I am not dr.

Maybe, someone that has als for a while, will get involved in our thread and can answer if thier reflexes changed.

I will ask my dr the next time I go back.
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