I'm a 43 y.o. male with widespread fasciculations/cramps (legs, arms, back, neck, throat, face) for over 7 months. Constant pain in center of back between shoulder blades. Occassional burning pain in shoulders/arms/calves. Feel more fatigued, no obvious weakness. EMG in Feb 05 at Mayo Clinic was abnormal (Fasciculation potentials with varying long duration complex MUPs in a right L5, S1 distribution, with fibrillation potentials only seen in the gluteus maximus. Varying MUPs noted in some right upper extremity and left cranial innervated muscles, without abnormal insertional activity. Single fiber EMG of right deltoid, was normal with no increased jitter detected). Physical exam/labs were normal. MRI showed stenosis/disk herniation of lumbar spine. Dx with benign fasciculation's and lumbar stenosis. Repeat EMG in Aug 05. I also have tightness in throat and difficulty swallowing some foods (coconut, grapes, cereal, etc.). Small pieces of food come back up for serveral hours after a meal. No weight loss. ENT exam normal. Barium swallow test normal. Gastro endoscopy/w dil showed narrowing in esophagus. No improvement with Prevacid or with dilation. Gastro wants further testing to r/o motility disorder.
1. If this were ALS wouldn't I have more noticable weakness?
2. Can Bulbar ALS effect throat muscles before effecting the tongue?
3. If this is Bulbar ALS wouldn't it have progressed faster?
4. If this is ALS will my repeat EMG show significant changes?
5. Can benign fasciculation/Cramps effect throat muscles?
6. What other things could this be if it's not ALS?
Thanks!