I spoke to our autonomic disorder specialist Dr. Bob Shields who also happens to be a neuromuscular specialist about your case. He said that it would be extremely rare for someone to have autonomic dysfunction with MMN due to the pathophysiology of MMN. And I could not find any association in the medical literature. In this case, the EMG would be extremely vital in the diagnosis of your condition and should be done at a major academic or clinical center for optimal quality. If you are in the area, Dr. Shields (a very warm and compassionate doc) would be happy to see you as a second opinion.
As for your second question, clinically ALS has both upper and lower motor neuron findings whereas MMN is only lower motor neuron findings. Your post says "Dr." so forgive me if I am overexplaining, but this means that brisk deep tendon reflexes and extensor plantar responses (UMN)in addition to muscle wasting/atrophy and fascics (LMN) can be seen on the physical exam of ALS patients whereas only LMN signs are seen in MMN. There are also some EMG findigns that can distinguish the two. Again, your case sounds complex and may deserve a second opinion with a neuromuscular specialist. Best of luck.
Thanks for your reply. I should have explained im my post that I did have an EMG - two infact, two months apart, which showed conduction block. The first neurologist I saw said he didn't know what was wrong with me so I asked for a second opinion. I then saw another neurologist who said I had MMN. I do have atrophy, muscle twitching, brisk reflexes, stiff painful calves, muscle shaking on exertion, which he all put down to MMN. I am worried I may have ALS or Motor Neurone Disease as we call it here in the UK. Can ALS be mistaken for MMN?
I have had symptons of MMN for approximately 14 years and have had MMN diagnosed for last 7 years. I am now 39. I am replying to give some detail for those who may be recently diagnosed and wondering what's ahead. The disease started with a slight tremor in my left hand at around about 25 years of age. Currently, my left hand has no finger extenstion, I can't grab or hold items in that hand & I'm now a one handed typist. I have weakness in the left arm, some muscle loss - but really no one can see that in my normal day to day activity. My right hand is detoriating very slowly, at present I can still type but my hand writing sucks. I have twitches all over my body from time to time - but there's no pain and again, no one would know that unless I told them. I have very occasional painful cramping.
I have had intravenous treatment which was very succesful, it returned nearly all if not all my strength and functionality, but it only lasted about 3 months. I had the treatment twice about 6 years ago - not long after MNN was first diagnosed. I chose not to continue it because at the time I felt my incapacity did not warrant the risk of transmittable blood product diseases. I am at the point of considering the treatment again because of my increased incapacity. However I know this time that once I say yes - it's a rest of my life commitment to the treatment until a different treatment or cure is found.
I gather this disease presents differently in different people. For me it's been an annoyance rather than a dramatic life changing event. I look forward to a cure that is more long term and less risky then the current intravenous option. I count my blessings - there are other neurological diseases out there which I understand to be far more devestating. If I can help anyone with my experience - happy to do so.
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