Unfortunately back again w/ foot drop

hmj82

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Hello,

It's been several years since I've even visited this board. Fortunately, a lot of the worries / concerns about how I was physically feeling have gone away and for the last year or two most of my symptoms (twitching, muscle tightness, muscle cramping, etc.) have gone away or only occur very sporadically when I'm stressed. Hence, I haven't visited this board at all in years. I thought I was finally able to put my fears away.

Fast forward to the past couple of days.......I developed foot drop with my right foot. Confirmed today with my PCP (another doc in the group since my main PCP was busy). He said my reflexes were okay (checked knee and ankle), but there was definitely foot drop in my right foot. He prescribed me steroids and a lumber spine MRI which I have currently scheduled for 11/29. He thought that there may be a bulging disk pressing on a nerve in my lumber spine. I have no low back pain but I've been working from home for months in a not so great setup (plastic chair and table), so maybe that could've caused the issue.

I'm at a loss and terrified right now. I had clean diagnostics years ago, symptoms largely went away, and then now confirmed drop foot. Should I worry about this being ALS?
 

ShiftKicker

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Hi there- I'm going to link your previous threads here so folk can have a read to see what's been discussed and what explorations have already been made. It's been quite a few years since you were here last, so it's good for people to be able to review to provide the most appropriate answers.




 

affected

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Goodness me, you were told why your foot likely has this problem, (bulging disc) and yet you jumped to terminally ill after a couple of days of symptoms.
Go straight back to your doctor and discuss this so you can be told by someone who examined you, why that is nothing like what they said is happening.

I wish you the best, 5 years ago we worked hard to help you see why you didn't have ALS, this time, read this post really carefully to help you.

 

Nikki J

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Your previous symptoms do not factor in here. You have new foot drop the most likely explanation as noted above was given by the doctor. Another common cause is peroneal nerve palsy. ALS is way down the list of causes
 

lgelb

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+1 -- time to upgrade your work setup. Try to find a chair that is for "active sitting" and make sure your desk has your computing device at an eye level that helps you elongate your spine. I would also amp up your stretching, walking, tai chi, whatever helps you keep in balance.

Best,
Laurie
 

hmj82

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Update:

I was able to get my lumbar spine MRI bumped up to this morning and it came back completely normal.

Waiting for a call from my PCP for next steps but I'm absolutely terrified. Drop foot with a normal lumbar MRI. I'm consumed with fear right now.
 

Nikki J

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Peroneal nerve palsy does not usually show on mri. It does show on ncs/ emg so when they order an emg do not freak.
 

hmj82

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Thank you for your response.

I did hear back from my PCP and as you suspected, he wants me to get a NCS/EMG done that will hopefully show the nerve compression you've alluded to in your posts and I can undergo some very intense.
 

hmj82

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My doctor scheduled my NCS / EMG for 12/8/21.

The steroids I've been on has made the loss of sensation along the midway part of my outer shin to the top of the toes go away for the most part. I was on a 6 day steroid pack with yesterday morning being my last dose. I can move my toes up and foot up to a degree just not nearly as much as my left foot. I still can't heel walk on my right foot. The foot just collapses when I try to do it.

I'm definitely praying this is the localized nerve issue you referred to in your previous thread.

I increased my appointments with my therapist in the meantime.

Thank you all for your responses.
 

hmj82

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Good news!

I just got back from my EMG/NCS and Nikki, as you suspected, the doctor said it was a peroneal nerve compression most likely caused by leg crossing, sleep positions, etc. Nerve is only operating about 50% functionality right now but has been improving significantly over the last week, so she thinks this should fully heal in a couple of weeks/month. A lot of the strength in my foot has returned significantly over the past week so another very encouraging sign. The doctor said all other signs from the test were good and no indications of a muscular issue. Thanks for the replies and hopefully this can be another wake up call / life lesson to me.
 

Nikki J

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Thank you for letting us know. You are far from the first person here to leap past common causes and focus on ALS.

Best wishes for a long and healthy life
 

hmj82

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Waiting on a call back from my PCP to formally go over the results but my test results and write up were as follows:
1639076153451.png


1639076101011.png



The doctor told me that my EMG was normal but there looks to be some abnormalities. Now, I'm freaked out because the doctor yesterday told me my EMG was normal but per the above there were fibs, sharp waves, and increased insertional activity.
 

Nikki J

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1 muscles that share common peroneal nerve innervation - in other words where you know you have damage
and
2 subacute denervation changes - not an ALS pattern and consistent with your known nerve issue.

emgs show many things not just ALS. The pattern matters.

3 you have had some improvement in your symptoms. That does not happen with ALS
 

affected

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Great result, congrats!
Hopefully when your doctor can get you on a path to wellness again now.
 
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