ALS or Cervical Myelopathy ?

[Jack104]

I had a diagnosis of ALS 5 months ago.
Symptoms;
Fast Reflexes
Fasciculations: Arms, Chest & Legs
Muscle wasting and loss of some functions of Hand.

Note: I think that the diagnosis was way too quick.

After the diagnosis I had an EMG which showed normal nerve conduction ( except denervation of the arm I think ?)
An MRI of the spine showed a herniated cervical disc C6/C7 with Osteophyte formation, though not causing an obvious radiculopathy.

I started to develop sensory symptoms: Intermittent Pins & Needles in Hands and Feet and electric shocks & "sharp pins" into feet and rest of the body, especially when moving head & neck.
Note: I had a painful stiff neck.

I went onto Non Steroidal Inflammatories 2 months ago and have had a definite improvement (small)in my hand and the pain in the neck has gone.

What I think could be happening is that the area around C6/C7 is swollen affecting the nerve(s) to my hand & arm and also pressing on my nerve roots & spinal cord to cause the fasciculations below the level of my arms.

Is this possible ??

All my symptoms ( Hand and fasciculations) seem to vary with my neck position ( worse with head forward).
Note: The MRI was done with my head back, could it show something different with my head forward ? e.g Osteophyte protruding into spinal cord etc ??

I have been told by the Neurologist that I would have to be compressing quite a few of the nerve roots in my spine to get fasciculations in arms and legs.

Is this true ??

I believe that with ALS, fasciculations happen when control of the muscle is lost and therefore it would become apparent quite quickly...i.e weakness would be noticed ??

How long does it take for weakness to become apparent after fasciculations have started ??

After 5 months I seem perfectly normal in the rest of my body (except for the fasciculations which can be quite intense) and I have had  a small definite improvement in my hand.
I haven't lost weight and do not get tired.

What do you think ??

[atwitsend42]

Hey Jack,
Hope your doing well.
What anti-inflammatories are you taking? I just went back on Celebrex after 4 years off due to warnings of Cardio issues. I'll take the chance at this point.

[Jack104]

Thanks for the advice Atwitsend.

I think your right to go with your gut feeling.

My hand is improving with Antiinflammatories.......so I'm hoping it is a myelopathy that can be sorted.

[atwitsend42]

Jack,
Your case is very similar to mine. Though I've never been officially diagnosed, the neurologist told me at my 1st appt. that she thought it was ALS. Looking back, I also think this was pre-mature. She never read my (long) medical history, which includes:
1) Bi-Lateral carpal tunnel.
2) Strongly suspected elbow neuropathy.
3) Varing degrees of Cervical problems from C-2 C3 thru T-1. Refered to as both Spondolysis and canal Stenosis. Both can cause brisk reflexes.
4) "Brain Lesion on Brain Stem" Does not seem to be malignent.
This was 2 1/2 years ago. I'm pretty much at the same point though my right hand has gotten weaker. I also have cronic neck pain and headaches, along with urinary frequency issues that urologist seems to think are neurological. Have gained over 30lbs in that period.
All off this make no difference to the neuro who says "its ALS until proven otherwise".

I've been surprised how myopic she has been. As even she said, there are 40 dieseses that mimic ALS. Why not start testing for those?

My advice is follow your gut. Keep asking questions and find dr.s willing to address your concerns and questions. It aint easy as I'm still looking after 2 1/2 yrs. You have the most at stake.

Good Luck