slowly progressive weakness

[fay57]

Dear Dr,
I have had symptoms now for ten years. I will list below..
neck pain
migraine
fasciculatios
muscle wasting in thenar eminence
weak arms and hands
more lately weakness in legs
difficulty with walking up stairs
fatigue
pallor
general feeling of illhealth
I have had abnormal EMGs  which shows large polyphasic units ? and fasculations among other things. it said I had slowly progressive motor problem .
I have not had much luck with my neurologist
who dismisses me , said test results meant nothing . I am concerned that I could be missing out on treatment to improve my quality of life which is not very good at the moment. From my own research this sounds like multifocal motor neuropathy ? for which there is treatment. I am due to have a EMG in a few weeks but unless they make a positive diagnosis I am in the same position as before. Do you have any suggestions

[fay57]

Dear Abhijeet,
The neck pain started twenty years ago by itself. Mri shows tiny syrinx ,neuro says too small to cause symptoms . I also have cervical spondylosis long standing.Yes you are right I wrote symptoms as they appeared.
About five years ago a neurologist diagnosed motor neuropathy based on Emg results ... widespread  chronic denervation and acute in only one muscle.  The Mri has ruled out cord compression which is good news.  ISince then he retired and I have had no luck with replacment who has dismissed the problem . It certainly has got worse with weakness starting now in my legs . I am due for emg in a few weeks .  Would MN cause general ill feeling and fatigue. I am currently using fentanyl for some pain relief but now have started waking in the night with bad pain in my back and legs , I am deserate for some answes and treatment , this has dragged on for so lng with no definate diagnosis or treatment. I really appreciate you taking the time to answer my post . regards fay

[Abhijeet Deshmukh, MD]

Hello.

Can you elaborate a little more on the neck pain? Did you get the neck pain after any injury? DO you have stiffness in the neck muscles as well?

More importantly, do you have ay MRI of the neck spine done? As I was reading your symptoms (which I think are in the order as they appeared), I got an impression of a cervical cord problem. It may not be the case, but was it ruled out by MRI? All your symptoms actually fit into a cervical cord compression. Even the headaches can appear as a result of cervical cord problem.

Long duration polyphasic units suggest slow conduction in the muscle fibers!

Regards