Motor Neurone Disease or Cervical Myelopathy or MS or just me!

Gorodish

New member
Joined
Nov 18, 2024
Messages
4
Reason
Learn about ALS
Diagnosis
00/0000
Country
UK
State
LL
City
ruthin
Dear friends
Thank you for reading this. 59 year old male, UK based. Generally really mentally and physically healthy (walked a Marathon 2 months ago). Perhaps you can help put my mind to rest.

In March this year I noticed a feeling of clumsiness in my left hand - hard to pin down, but made typing a bit harder and holding and using a fork a bit alien. Some occasional deep ache in the arm. At the same time, I noticed a sharp ice-pick crampy pain in my upper back when I'd been driving a bit. It would never appear at rest/ sitting/ lying down. I went to the GP in the summer and he said that it seemed to correlate with the findings of a MRI I had 2 years ago whci found evidence of bone spurs in my cervical spine. Suggested it was a trapped nerve in my spine, and that physiotherapy would help. I started a routine of neck extensions and yoga.

It didn't get better. In fact the arm has felt a bit weaker and more clumsy (like a heavy, dead arm some of the time), now joined by fasciculations in that arm/ trembly sensation (mostly in bed on waking that usually seems to alleviate if I lie on my back) as well as both calf muscles and eyelids etc. I also have had weird numb sensations in my legs that get more and less at different times of the day. I have an occasional hoarse voice and often need to clear my throat, with feeling of globus.

I went back to my trusted, experienced physio yesterday and she said that in the absence of any improvement, it isn't likely to be a trapped nerve. She then did a neuro exam which found - unitateral Hoffmans (left hand side), bilateral Clonus, and negative Babinski reflexes. She's suggested I take these results (which Dr Google suggests are indicative of an Upper Motor Lesion) to my GP to get a neurologist appointment. I then scared myself with the possibilities.

I would have sworn that with a stiff, tender and maybe arthritic cervical spine, that the potential is for Cervical Myelothapy is there, but does that correlate with a single side Hoffmans? Where is MS in all this? I had Covid at the start of October, can this correlate?

I appreciate the advice will probably be to see the Neurologist, get the tests - only s/he can say, and don't get stressed about self diagnosis. It is the advice I'd give to a friend who came to me with this. But it helps to write this and share. Thanks for a very helpful Forum.
 
There are certainly post-Covid syndromes that involve the kinds of issues you describe. Your self-advice is dead on. Updating the MRI will provide more information, as will a full neuro exam. Clonus in itself is not pathologic, depending on extent and other findings. Nor is a positive Hoffman's worrisome in itself; 3% of the general population reportedly displays it. However, because it's unilateral, I would expect imaging would be repeated to rule out a tumor or other lesion.

ALS doesn't seem to enter into this at all, nor MS, as I read it. And yes, myelopathy can be unilateral or more severe unilaterally.
 
Thanks @lgelb I appreciate the reassurance. I’m thinking having reread the consultant letter from 2 years ago along with a bit of selective reading that it’s probably Cervical Myelopathy. It’s too slow progressing to be ALS/MND. Will update when I get more information.
 
A brief update. I saw a Neurologist (specialist from the Walton Centre in Liverpool, a Neuro centre of excellence in the UK), just before Christmas. She added brisk reflexes on the left arm and leg to the list, but was very clear that her primary concern was that it is related to my potential spine myelopathy/ radiculopathy. She ruled out ALS for now because of continued lack of weakness. MRI booked in next week.

Despite this I am still very anxious. I’ve had continuous fasciculations - calves, eyes, shoulder etc since Christmas. Was very spooked by getting mild cramping in my calves yesterday- a new symptom. Can this be caused by radiculopathy like the twitching?

Will post back with MRI results just to hopefully give completion to the story. Thanks for all your support.
 
Yes it could. Excellent news that Walton Centre is leaning away from ALS. Let us know when you get a definite answer
 
Hi all, thought I’d come back with the MRI results. It’s all cervical spine related, severe foraminal compression and related nerve impingement at C6 and C7, plus some spinal cord impingement too for good measure. I’ve been referred to neurosurgeons.

It’s crazy but I’m really happy with this.

Thank you did the reassurance you give to scared people (health anxiety is a bigger factor than I ever imagined) and most of all, PALS.

Good luck, Tom
 
I am happy for you too. Thank you for sharing
 
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