Neurology referral

[Ellek]

Hi l am going to see another Neurologist after seeing a GP yesterday who feels l need a second opinion. Last August l gas the drug Prolia and two weeks later had profound weakness in my legs. I changed my diet and took sips and things improved. Then in Dec l got really sharp pains and pins and needles feet. I have had constant twitching in both calves and pain and stiffness. I have had periodic cramping in fingers and now they are weak too. I have been told by a physio my calf muscles gave atrophy. I was told not ALS buf MRI showed few white lesions ( prob smoking) and LP normal. I am 59 Caucasian female

 

[lgelb]

I'm sorry to hear of these troubles but as you say, they have nothing to do with ALS. There are many reasons for muscles to atrophy, and Prolia has been associated with low calcium, which could relate to some of your issues, although you are a ways out from the injection. It is certainly worth making sure you've had an electrolyte panel, calcium, magnesium, and PTH tests, and tinkering with your diet and exercise to see if you can feel better. As you know, brain lesions are not associated with ALS, either.

Best,
Laurie

 

[Ellek]

Thanks but all my bloodwork is normal. I was told that white lesions can be seen on with ALS. I am very frightened as l do have muscle atrophy, twitching and the GP was quite certain.

 

[lgelb]

A GP is not qualified to diagnose ALS, which is confirmed through a combination of examination, history and specialized testing. I'm not saying the Prolia is to blame, or a systemic condition. If you have explored both, that still leaves a lot of territory between those notions and ALS. When you say "another neurologist," are you saying that you have already seen one?

 

[affected]

Definitely a GP is not qualified to diagnose. Ask to be referred to the neurology clinic at the Royal Brisbane if you want peace of mind. Usually you can get in within a couple of months. I would not suspect ALS at all without loss of function as without that your symptoms don't really point to anything sinister. (weakness that got better is not ALS)

 

[Nikki J]

A few white lesions that looked like due to smoking does not sound at all like the MRI changes that can occasionally be seen in ALS ( and no one can be diagnosed by mri even if the mri is suspicious). ALS changes when they happen are extremely specific and focused. We just went through this with another Aussie. If you share your mri report summary it would be helpful