Worried about my husband

jmm

New member
Joined
Feb 19, 2025
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5
Reason
Learn about ALS
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US
I will try to condense this as much as possible. My husband is 54 years old. Approximately 3 years ago his right calf- gastrocnemius muscle stop working. He did wake up at night with severe cramping prior to this. His muscles had atrophied, and he could no longer stand on his toes-right leg only and no pain. He went to his primary care doctor who sent him to a neurologist who performed an EMG which was abnormal and showed issues with the nerves related to L5 and S1. Back to the primary care who ordered an MRI which showed everything was OK and then to an orthopedist who prescribed physical therapy. They isolated the muscle to try to build it back up with no success. They concluded it was a fluke and not to worry it wouldn't progress...

Last summer, approximately 2 years after the right calf stopped working, his left calf has now stopped working. He can no longer stand on his toes and feels like he is walking in sand. He went back to the neurologist, and he performed another EMG. It was abnormal and showed issues not only in the lower extremities but in his upper back and biceps as well. I wish I had the results to share and will try to get them and post them. He was a bit upset that my husband wasn't referred back to him 2 years ago when they couldn't find any answers.

He has since had another MRI which showed severe spinal stenosis in L5. A muscle biopsy which had no definitive findings. A spinal tap which came back normal. As well as many blood test for a variety of illnesses.

He was referred to Duke neurosurgery. The neurosurgeon said while there is severe stenosis in L5 he doesn't have any symptoms that correlate with that issue. He has no pain, and the nerves effected in his calf are not the ones that relate to L5. He asked questions that led me to think he was considering ALS, especially dealing with twitching. He hasn't had any twitching that he can recall.

He has another MRI at the end of March which will include his brain, cervical and thoracic area. He has and appointment with a Duke neurologist in June and another EMG scheduled at the same time. Hopefully we will know more after these appointments, and I feel hopeful they are determined to figure out what is going on.

I am just curious as to your thoughts on his symptoms related to ALS.
 
Has his right leg progressed in three years? It would be unusual for als not to progress at all in that time frame

If you get the emg and are able to share deidentified results we might be able to comment better

The plan for more mris sounds a good one and the need to repeat the emg would indicate whatever they saw wasn’t completely diagnostic

Waiting for tests and appointments in hard I know
 
His right leg has not progressed any further. He does have issues with his thighs and numbness. He has orthotics which help him to "have a spring in his step" and not feel like he is walking in sand.

Waiting for appointments and test results is very hard. Thank you for any insight and information you have to share. I really appreciate it.
 
Has he lost bulk in the L leg as well? Yes, the EMG report as well as the last MRI would be helpful.

It sounds like he is on the right path now, and that there is still considerable room for doubt as regards ALS.
 
Yes, his left calf is smaller, but it is not quite as small as the right.
 
Here are the MRI results. This is from September 2024

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Yesterday he went for an MRI of his brain, thoracic, and cervical and the results did not show anything that can explain the symptoms he is having

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