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Active member
Feb 28, 2008
Learn about ALS
I'm pretty new and just have a few questions because I seem to get conflicting information. Is it common for PLS or ALS to start on just one side of the body? Also, my neuro says that I have brisk reflexes. What does this mean and which of the several hundred tests that he conducts every visit tell him that my reflexes are brisk? Last question for now... my neuro often asks me to tap my toes (with my heal planted on the ground)in steady beats. I can do this with my right foot just fine, but when I try it with my left foot I can't seem to bring it down in a steady rhythm. I can lift the toes up just fine, but when I bring the foot down to tap I end up tapping in rapid uncoordinated beats. Any ideas what this might be caused from? It's rather amusing, but also bothersome.
Sounds just like how mine started. Left side only. Now slowly moving to the right.

Lateral corticospinal tract
From Wikipedia, the free encyclopedia

The lateral corticospinal tract (also called the crossed pyramidal tract or lateral cerebrospinal fasciculus) is the largest part of the corticospinal tract. It extends throughout the entire length of the medulla spinalis, and on transverse section appears as an oval area in front of the posterior column and medial to the posterior spinocerebellar tract.

Its fibres arise from cells in the motor area of the cerebral hemisphere of the opposite side.

They pass downward in company with those of the anterior corticospinal tract through the same side of the brain as that from which they originate, but they cross to the opposite side in the medulla oblongata and descend in the lateral funiculus of the medulla spinalis.

The lateral corticospinal tract moves limbs and digits.[1]

a umn lesion on one side of the lateral column will produce symptom on opposite side ,as mnd is selective in where/amount of neurones involved .
Thanks for the replies. Any thoughts on what it means to have brisk reflexes and what that amusing toe tapping could be?
I think the clonus could cause your tapping you are talking about, and that would make sense with your brisk reflexes, all of which are upper motor neuron symptoms.
I know you said you had a nerve conduction test, that is usually done with a emg, and the emg is the second part of the test when they place little needles into the muscles to check for the health and strength of the muscle. Let me know more.. Hoping
I've been diagnosed with PLS since Dec. of 2006. The symptoms started in 2004 just in the bulbar area. I can't speak and have trouble with swallowing. The left side of my face is weaker than my right. In January of this year, my left leg started to drag at times. Usually when I got nervous or excited or cold. I noticed also that when I tapped my foot, the right foot is fine and fast, but my left is very slow. I saw my neuro, and she did some clinical testing of the muscle-bulk and reflexes. She stated my reflexes were brisk and my muscle-bulk good, which means all upper motor neuron.
This whole process has been very gradual for me. Do you have any problems in the bulbar area?
I don't know how bad the swallowing can get. My neuro gave me an article on the PEG feeding tube, but I won't go there. I am a born-again Christian and if God wants to take me home, I am happy to go. I don't want to stick around here by artifical means.
Hi Judith, I don't have any speech or swallowing problems yet. I suppose this may come with time. I share your faith and hope in what lies ahead for us. I've written some thoughts on this topic elsewhere (the role pain and suffering plays in our faith) but I am not sure if the rules of this forum allow me to post the URL. I'll find out or will get back to you on that as I think my other writtings may help with the spiritual side of things.
hi judith

my symptoms started in my legs 8yrs ago but i started with slight bulbar problems 1yr ago. the past several months these have progressed very fast. i can barely chew at all,swallowing getting worse along with speech. also excess saliva and i have to try with difficulty to swallow it and sometimes choke. i was looking on web today for bulbar issues and came across a test for tongue palsy. look in the mirror stick your tongue out and say aaahhhh, if it goes to the side it is posotive. so i tried it and my tongue went to the right, very unnerving.
i have more weakness in my left leg, i have hypotonicity/flaccid paralysis in that one.
welcome to the forum
best wishes
Hi Judith,

I don't have speech or swallowing problems yet. I also share in your faith and the hope that it provides. I'd like to provide a link to my writings on this topic (how pain and suffering and our faith co-exist) if I can figure out how to get the link to you. Everytime I click on a member's profile it says I don't have the access rights to do that :( Anyway, I don't know if I can link to it here or if it is against the rules. However, I'll find a way to get it to you. Maybe by private message if I can figure that out.
i think when you first join as you just have you are not able to send pm's straight away, it's probably a vetting thing to keep the looneys out lol. are you a looney lol?:-D
No- I'm fairly normal. I wonder how they guard against a normal person becoming looney once they join though! It seems to me that all looneys probably start out normal.
Olly the Doctors look at the Uvula (that thing that hangs down ) I would suppose the tongue would do somewhat the same .Usually going toward the stronger side I beleive ? as upposed to the weaker side ?
I did find something for you to try though . when you find your throat seems to be closing up . Take and pinch your nose shut ,hold your mouth closed and blow hard . I tried this and it seems to open the throat up if just a little ( the air pressure ) . ? Something to try Geo
Hi Promethoeus. Your full membership sill be kicking in soon and you will be able to PM folks. As for the link to the other site, as long as it does not sell a product or solicit money for a non-ALS cause I suspect it will be OK. Are you talking about a blog or a personal webiste? Those sites usually are OK. We just don't want this site to become a spring-board for someone making lots of money! :-D

Hope this helps! Cindy
Thanks Cindy. That makes sense. Just a blog- not making any money off it (I'm not that good a writer) but it's an outlet.
I can see profiles now! They must have decided that I'm not so looney afterall :)
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