I'm a physically active 58 year old male. I have a background of hay fever and a post-nasal drip. The latter has made me hoarse and made my voice weak over the last 4 or 5 years, and since then I also have tinnitus in both ears.
Until about 9 months ago I had sporadic neck pain, such as after sitting in front of the computer for several hours. This neck pain has become more frequent in the last 9 months and has been accompanied by crepitus in my neck when I turn my head or run. More recently I have had intermittent paresthesia in my neck and fingers, and pains in my arms. A cervical X-ray revealed degenerative disk changes between C4 and C6.
Over the last month or so the pains in my arms have become more frequent, and my legs are sore since running a mile or so to catch the bus the day before yesterday. I also get painful cramps in my left calf when waking up.
In addition, in the past month I have had fasciculations over my whole body, from my eyelids to my feet. They have become more bothersome recently and last week I went to the emergency room and was seen by a neurologist, who found "mild distal muscle weakness". Another neurologist had previously found mild atrophy in the deltoid and interosseus muscles, and ordered EMG/NVC along with a cervical MRI.
Today I had the EMG/NCV done on my right arm, leg and cervical spine, and the technician reported as following:
NCV: Latencies, amplitudes and velocities within normal range, except borderline decreased right tibial amplitude. Prolonged F-waves in right tibial nerve.
EMG: No signs of acute denervation, widespread fasciculations in all nerves examined besides paraspinal cervical muscles. Increased motor units (amplitude, duration, polyphasic) with reduced recruitment in following muscles:
Right Medial Gastrocnemius
Right Vastus Lateralis
In conclusion: Findings may suggest MND. For clinical correlation and neurological workup.
My question is: Just what kind of MND (motor neuron disease) might these findings point to? Could it be ALS, for example? Or is it impossible to suggest a diagnosis until after doing the cervical MRI?
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