Worth Seeing Neurologist?

[jd16]

Hi All,

First, my heart goes out to all those diagnosed and caregivers. My recent exposure to ALS has given me a new appreciation for the difficulties that accompany such a terrible disease. I am a 27 yo male (who has read the stickies) and am curious as to what I may or may not gain from a visit to a neurologist.

I have 2 diagnosed herniated discs in my l4-l5 and l5-s1 (right side, l4-l5 3mm) that i suspect is from injuries sustained over 1.5 years ago (though my MRI is from only 2 months ago after symptoms from re-aggravating). At first, only numbness and tingling (pointing away from ALS) but have since noticed relative weakness, confirmed calf/thigh atrophy (1 cm in calf) and fasciculations in my right leg (mainly calf and foot). I have started PT and have not made a ton of progress in the strength department and now am concerned that there may another issue.

After some research I found ALS can present with some, but not all, of my symptoms and have since been very worried. Knowing my age, lack of family ALS, and known diagnosis would I even see benefit of going to a neurologist at this point? Would the nuero even waste his time with additional testing, EMG, etc given my known disc issue? A PCP did refer me but honestly the visit was pretty lackluster as he didn't check strength, reflexes or really anything.

I want to be assured that my issues are from the obvious/diagnosed injury and not the very rare (and coincidental) case of ALS, but also do not want to waste a nuero's time that could be spent with others needing care. Any advice is appreciated.

Thanks

 

[lgelb]

I would give PT a fair shot first. Sounds you just started and it takes generally weeks to see clear benefit in terms of rebuilding strength.

ALS is very unlikely but to rule out a treatable exacerbation of your spine issues, one neurology visit is appropriate. Not clear if you have already had one since the MRI, but if you did, I wouldn't see the point of going back unless you and/or your PT feel that things have gotten worse. If you didn't, nothing wrong with checking in. You could ask the neuro via portal to read the MRI if they haven't and advise whether a visit is appropriate.

I would also ask the PT to work on strategies to make sure you know how not to "re-aggravate" the problem.

 

[jd16]

Thank you, and while I am logical enough to know that the nuero will tell me what I already should know, I think that may be what I need to move forward. Thanks for the advice.

I will also come back and respond to the thread after my visit/additional testing as it has given me great comfort in knowing so many have this intrusive thought and ultimately have no issue or issues that are very fixable (like my case hopefully).