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Neurology (Expert Forum)
endplate disease
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endplate disease
by TomK, Sep 27, 2003 12:00AM
I am a 46 yr. old male. For about 4 years, I have had off and on symptoms of leg, upper arm and back weakness. I am now consistently weak in the muscles used to bend down and back up - it is very difficult for example to bend down to pick something up and then straighten back up. As a result of the back/hip weakness my gait feels choppy.
I also have frequent (dozens of times through the day) when muscles in my shoulder, arms, hands 'twitch' for about 5 seconds, strong enough to easily be seen through the skin, and if it involves fingers, they will actually move back and forth.
I had an EMG about three years ago which noted some minor fibrillation but otherwise normal. A neuro exam at that time was also normal.
Bloodwork has been normal except elevated monocytes about 12 months ago, but has not been rechecked. I see a rheumatologist every four months, he hasn't made any diagnosis but prescribes indomethacin 25 mg x 2 daily which helps a little.
I just had a cranial/cervical/lumbar MRI in response to blurred vision in one eye which lasted about three days. The MRI showed no abnormality in the brain, minor disc bulge at L4 and L5 (which I assume is unremarkable for my age) but also "moderate spondylosis at L5-S1" and "reactive endplate disease present at L5-S1, moderate in severity."
What is endplate disease? Does the 'reactive' mean reactive to the spondylosis?
Could the muscle weakness, spondylosis and endplate disease be caused by an autoimmune process, such as Lupus or Myesthenia Gravis?
I also have frequent (dozens of times through the day) when muscles in my shoulder, arms, hands 'twitch' for about 5 seconds, strong enough to easily be seen through the skin, and if it involves fingers, they will actually move back and forth.
I had an EMG about three years ago which noted some minor fibrillation but otherwise normal. A neuro exam at that time was also normal.
Bloodwork has been normal except elevated monocytes about 12 months ago, but has not been rechecked. I see a rheumatologist every four months, he hasn't made any diagnosis but prescribes indomethacin 25 mg x 2 daily which helps a little.
I just had a cranial/cervical/lumbar MRI in response to blurred vision in one eye which lasted about three days. The MRI showed no abnormality in the brain, minor disc bulge at L4 and L5 (which I assume is unremarkable for my age) but also "moderate spondylosis at L5-S1" and "reactive endplate disease present at L5-S1, moderate in severity."
What is endplate disease? Does the 'reactive' mean reactive to the spondylosis?
Could the muscle weakness, spondylosis and endplate disease be caused by an autoimmune process, such as Lupus or Myesthenia Gravis?
Doctor's Answer
by CCF-Neuro-M.D.-CS, Sep 30, 2003 12:00AM
The endplate is the part of the verterbral bones which contacts the discs. When there is spondylosis or degenerative changes the bone at this junction can react. Muscle weakness may be the underlying cause for many of your symptoms, and yes lupus, and MG can cause muscle weakness. However, there are many reasons to have weakness, including muscle inflammation, metabolic dysfunction, or medication side effects to name a few. Perhaps having all of this re-evaluated by a neurologist would be reasonable. Then based on the findings a specific work-up can be instituted. Good luck.
