Worried that I may have Als

[Broncoman16]

Good Evening, and thank you to all of you great people and thank you for your time. i truly appreciate it.

Im worried I may have ALS. For the last 3-4 months I’ve had trouble swallowing, weakness in one arm, weakness in one hand, and fasciculations in my calf. My right forearm/wrist feel weak, and feels slightly painful at the use of my thumb/hand or when my wrist is bent. Feels like my hand and arm won’t work for a few seconds.

I had an MRI of my brain and cervical spine done, which came back normal (did it because they thought it might be a disc problem or pinched nerve)

I had a swallow study done, and the LSP saw dysmotility in the esophageal phase of the swallow. Everything else seemed fine with it.

I had my initial appointment with neuro. Reflexes and Neurologic Exam were normal. Had extensive blood panel done. Pretty much all seemed in normal range. Creatine Kinase was 70 U/L which says its still in normal range.

Neuro has me scheduled for an EMG next week on my upper extremity and hopefully my neck muscles.

Im a 34 year old male, and I feel weaker than i ever have. do you all think this could be als?

again, thank you all in advance for your responses and time.

 

[lgelb]

No, this doesn't sound like ALS. If nothing neurological is found on exam and testing, I would look closely at your sleep and keyboarding. For example, you could be rolling over on your hand/arm due to lack of mattress or pillow support or be restless for another reason. Even dysmotility can be an artifact of poor sleep or suboptimal diet.

 

[Broncoman16]

Thank you for your response. I will update with my EMG results next week if that’s okay? I don’t want to break rules of the forum.

can you or anyone else tell me if it’s even possible for ALS to present this way? Honestly the part that worries me alot right now, is that my creatine kinase dropped from 160 UL on October 9th to the 70 UL yesterday.

Can bulbar onset present this way? Or 100% of the time it affects speech first? Or is it a different part of the swallow that is affected first?

Would it be possible for one muscle in the right hand to be affected first, a forearm muscle next, and then move to swallow?

or does one complete limb or the bulbar muscles become completely affected before it moves else where?

thanks again! like I said, I’ll update with EMG results next week if that’s allowed.

 

[lgelb]

CK is not an indicator the way you are saying it. There are many factors behind that lab value, as for most blood levels. It is not a diagnostic criterion for ALS at all.

Your questions all relate to scenarios that don't apply in the timeline you describe. Feel free to post the de-identified EMG results when you get them.