fasiculations

My huband has been experiencing fasiculations that started in primarily in his left shoulder and now are more generalized.  He complains of weakness, fatigue, and lack of energy, weakness especially in the shoulder area. He does not have any pain.  However he does have some low back pain.  On exam, the doctor said that he is noticeably weaker on the left and muscles are less defined.  The EMG showed cervical radiculopathy at C5 and C6.  MRI of cervical spine was indicative of spondylosis.  Our concern is that this may be something more than degeneration.  He has an appointment with neuro June 26.  Are these symptoms consistent with spondylosis or more with ALS.  I think he appears generally depressed as well.  Any information you can give me will be of great assistance.  Thanks.

[CCF Neuro[P] MD, RPS]

Dear Elaine:

A cervical radiculopathy at C5 and C6 and a cervical spondylosis certainly could give fasciculations in the shoulder.  Usually, there is also a pain or numbness component to a radiculopathy. However, without pain or numbness does not preclude this diagnosis.  I am assuming that the EMG did not find any other abnormalities with the exception of C5 and C6.  I am not sure what to make of the lower back pain as this doesn't fit (nor would it fit a diagnosis of ALS).  Based on what you have told me, I would say that the fasciculations are due to the radiculopathy and/or spondylosis.  The criterial for ALS by EMG include 3 different muscle groups with fibrillation, fasciculations, or sharp waves all of which your husband does not have.  

Sincerely,

CCF Neuro MD

[Brain Lesions and low WBC]

Can't seem to find the right time to be allowed to post correctly. Sorry!!
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Can these problems be related and not two separate problems? The Dr.s here treat them as two and hasn

[Bobbi D]

Have you been tested for lyme disease?  You said you live in NH, but could you have visited CT or NY in the recent past and got bitten by a tick?  These symptoms sound pretty typical of lyme.

[Theressa]

No, I haven't been tested but since I didn't have the bullseye rash and couldn't remember being bitten by one the neurologist dismissed the idea. I haven't been to CT or NY within the last couple of years.