List of diseases to be rule out before diagnose

jethro

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is there any "manual", list of tasks needed to be checked, whatsoever which is used before diagnose with als?
i.e. liquor analisys, heavy metal analisys, blood work, mri etc etc
why am i asking this?
my neuro didnt check borrelia and heavy metals, saying: "oh, no... unfortunatelly, it is obvious that you have "pure" als".
ok, i took it.
i did borrelia/lyme tests by myself.
weak positive, so i dont believe it is.
heavy metals? that is what am i missing. did anybody have lead, mercury etc - elevated?
 

KarenNWendyn

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Whether to check heavy metals depends on the clinical context. Most cases of serious metal toxicity will have other symptoms such as anemia and more of a peripheral neuropathy with numbness and tingling. Those sorts of symptoms are usually not part of the presentation of ALS.

Lyme usually starts out with flu-like symptoms such as fever, headache, achy joints, and rash. The neuro symptoms come later and are often localized. There may be cardiac conduction abnormalities, and arthritis. Again, very different from ALS.

My doc also checked blood and urine tests looking for things such as lymphoma, myeloma, and autoimmune conditions.

That’s why it’s always a good idea to start with a primary care doctor for a good general evaluation any time there is a constellation of unexplained symptoms. EMG would not show an ALS pattern in these other conditions.
 

jethro

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...
That’s why it’s always a good idea to start with a primary care doctor for a good general evaluation any time there is a constellation of unexplained symptoms. EMG would not show an ALS pattern in these other conditions.
Not sure about NOT SHOWING ALS PATTERN. ALS HAS NO SPECIFIC patterns, and only we can see from EMG is about velocity of impuls, nerving/inerving muscles, amplitudes etc., nothing ALS specific.
remember there are diseases ALS-like vs cause-of-ALS, mimics vs cause. Hg poisoning is considered as a one of the causes of ALS.
tomorrow morning i go to make (for a very first time!) test for lead and mercury. my neuro did nothing except "concluded that it is obviously ALS" in a first meeting.
i'll check CK, Pb, Hg, any suggestions what else to check?
 
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KimT

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Mayo did heavy metal testing as part of my workup. They tested several. Later on I had a comprehensive heavy metal test along with vitamin and mineral testing. I already had diagnosis but I was looking to find out why I'm in so much pain and wanted to make sure I wasn't missing anything that might improve my general health. It was then that I noticed high free copper and I lowered it to normal with Gluzin. Other abnormalities, for me, were Hashimoto's, very low ferritin which I treated with supplemental iodine and iron. My iron has always been low so I need to keep taking supplemental iron with Vitamin C to keep it in the normal range. I don't think I was ever tested for Lyme but I did have a lumbar puncture, MRIs, and so much blood work I thought I'd need a transfusion.
 

mytmouz

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Vitamin B1, Tay-sachs, and West Nile virus were on the list for me, as well as what has been listed...
 

Clearwater AL

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Jethro, you did title your Thread "List of diseases to be ruled out before diagnosis."

For all...

In the early diagnosis process here is a list of diseases that may show mimic
symptoms of ALS a Neurologist may have to rule out. With ALS the EMG is the
somewhat "Gold Standard" test.

I know your post was related to heavy metal and borellia but I thought I'd pass
this onto all and new members concerned with ALS.

Anxiety
Myasthenia Gravis.
Multifocal Motor Neuropathy.
The Parsonage–Turner syndrome.
Spinobulbar Muscular Atrophy, or Kennedy's Disease.
Demyelinating Syndrome
Asymmetrical Spinal Muscular Atrophy.
Cervical Polyradiculopathy.
Facial-onset Motor Neuropathy.
Hereditary Spastic Paraparesis.
Primary Progressive Multiple Sclerosis.
Metabolic Myelopathies.
Corticobasal Degeneration.
Cervical Myeloradiculopathy.
Multiple Sclerosis.
Carpel Tunnel Syndrome.
Benign Fasciculations
 

Clearwater AL

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I need to make a little edit here.

On the first word of the list I wrote just Anxiety... it should have been
"Health Anxiety" which some consider to be a disease/syndrome.

On the last of the list I wrote just "Benign Fasciculations" which should have
been "Benign Fasciculation Syndrome" which some may debate if a syndrome
is a disease. Disease - Syndrome - Symptom... take your pick. :)

Kate... thank you for the "Thanks".
 

Lkaibel

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Yes, there are specific EMG patterns associated with ALS. Those are chronic and active denervation and short wave abnormalities. For my husband, the EMG in combination with foot drop was enough to lead the Neurologist straight to “strongly suspected MND” and to start rule out tests ASAP To be sure.

To clarify, at that point my husband showed these features in numerous parts of his body, including legs, torso, neck, and arms.
 

Clearwater AL

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I noticed that this Thread is "Being Watched"... no other Thread in this sub'forum
has that symbol. What's that about?
 

ShiftKicker

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I noticed that this Thread is "Being Watched"... no other Thread in this sub'forum
has that symbol. What's that about?
That's a thing that shows if you participate in a thread- it's different for everyone depending on what you comment on or post. You can also go to the top right of any thread and select "watch". That way the forum will compile a list of "watched" threads for you to make it easier to navigate.
 

Clearwater AL

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Edit. Notation solved. Thanks.
 
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lisa g

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Has anyone done any research on Ataxia? This is also something that mimics ALS symptoms closely. My husband came across an article, I was intrigued with the similarities of symptoms.
 
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