I am a 52 year old male who was diagnosed with sarcoidosis about a year and a half ago, based on chest x-rays and skin biopsies. At the time, I was experiencing some neurological symptoms (cramping and twitching in my feet and calves). My neurological exam indicated brisk reflexes and I was given an MRI of the brain and neck. There were several white matter lesions on the brain MRI and I was referred to a noted neurologist in Boston for a second opinion. He stated that the lesions were inconclusive but he believed that my sarcoid was still active.
About two months ago, I complained to my primary care physician of weakness in my left hand and arm. He noticed atrophy of the muscles around my thumb and consulted with my neurologist. I was scheduled for an EMG in a Boston hospital. On my return visit to my neurologist, he confirmed the weakness and atrophy, noticed some twitches in my hand, and informed me of the EMG results - "significant abnormalities consistent with Left Ulnar neuropathy". He also noticed what he called "thick speech" and I told him that my wife had made the same comment recently. He also asked about my neck and I said it felt a bit stiff recently. Now I am scheduled for an EMG of the tongue in a few weeks. He also ordered some blood work. One of the tests (Co-GM1 Triad Autoantibody) supposedly detects multifocal motor neuropathy.
Just last week, I thought I was having a stroke. A portion of the left side of my face went completely numb for about five or ten minutes and I noticed problems speaking. I was given a diagnosis of Bell's palsy and I am now on prednisone and acyclovir.
Q1. I was taking 30 mg. of Prednisone a day at the time of the brain MRI. Could that make a difference in the intensity of the white spots?
Q2. I have seen ALS listed in the differential diagnosis for ulnar neuropathy. Given the "thick speech" symptom, will a positive GM1 autoantibody test rule out ALS?
Q3. Is the facial weakness that I