need help with understanding the doctors report

[taratune]

My brother saw another muscle disease specialist and this doctor reports that he has progressive motor neuronpathy......but ALS cannot be excluded. He said the biopsy showed signs of nerve pathology not muscle pathology. He also said that "sparing of the left quadriceps reflexes suggests there is some cortico-spinal tract pathology, since that muscle is quite weak."

Can anyone help me to better understand what this means? I am especially wondering what the "cortico-spinal tract pathology" may mean because my brother keeps talking about a bulge and pinched nerve between his shoulder blades that is painful and makes him weaker.....if he lays on his back or sits down. He has had 2 MRI that do not show any problems.

Thanks for any help in understanding this.

Tara

 

[wright]

Hello Tara

I'm going to assume that if your brother has had a muscle biopsy, he has also had an EMG. What were the results?

As far as the muscle biopsy: there is a way to tell if muscle atrophy and weakness is caused by pathology of the muscle itself or by pathology of the nerves that innervate those muscles . . . and the differences are quite clear on the muscle biopsy.

Corticospinal tract pathology is another way of saying upper motor neuron dysfunction/death. Cortico (neurons of the cerebral cortex, which are the upper motor neurons) and spinal (neurons of the spinal cord, which are the lower motor neurons) and tract (another name for nerves). If the upper motor neurons are damaged or dead, their tracts that lead to the lower motor neurons are then damaged and causes the upper motor neuron symptoms (e.g. brisk reflexes, Babinski, Hoffman, spasticity).

Having said all of that: your neuro's are obviously not yet convinced that he has ALS, so hang in there and let us know if there is anything else we can do to help you.