Does this sound like Als ?

[Wiltymumma]

Hi there I would appreciate it if you would give me some advice with regards my husband’s symptoms. He has a painless foot drop which makes walking difficult, his balance is bad and he has fallen on a few occasions. He has no sensory symptoms. His GP referred him to a neurologist before Christmas and according to the report back to my husbands GP he found a mixture of both upper and lower motor neurone signs. He has recently had a MRI of brain and spine plus some blood tests to check for vit b12 amongst other things. My husband has been seen by a neuro physio as the neurologist has categorised my husband as having a “slowly progressive neurological problem”.

I would be interested to know if this sounds like ALS - I did ask the neurologist at the initial appointment and he said it wasn’t at the top of his list of differential diagnosis though it was a possibility - the reason he said this was that the symptoms progression in his opinion didn’t fit the time line of ALS - my husband had a mild limp start 4 years ago but the foot drop started approx 2 years ago. It has progressed significantly this past year and now he can’t walk more than 15 or 20 minutes due to the foot drop. Obviously I’m very worried about ALS and the next appointment with the neurologist is not for a while yet so I wonder if you can put my mind at rest.

best wishes and thanks in advance

[MNDConnect]

Hello Wiltymumma

I'm sorry to hear about your husband's symptoms. There are many conditions which can cause upper and lower motor neurone symptoms as well as a neurological problem. There are all sorts of motor neurone disorders that are separate to ALS or MND.

It's impossible for anyone on the forum to say as to whether this may be ALS and only a neurologist could comment on this.

You husband's symptoms are progressing very slowly and so wouldn't be typical of ALS but there are different types of motor neurone disease (with ALS being one of them) as well as various other motor neurone disorders.

I am sorry as this really doesn't answer your question. If you have questions or would like to talk to someone then please do feel free to send us a private message, ring us on 0808 802 6262 or email us at [email protected]

Best Wishes

Rachel
MND Connect Adviser

[Suefromwakey]

Hello Wiltymumma,

Cant give you a diagnosis but suffice to say my husband was recently told he has PMA - it took best part of 2 years for a diagnosis. I understand that PMA can indeed end up as ALS as others on this forum will say.

Your husband sounds incredibly like mine. If you want to PM me feel free,

Best wishes

Sue

[Wiltymumma]

Sue

Thank you for your swift reply. I’m sorry to hear about your husband’s diagnosis - how did you manage to wait so long for the diagnosis ? I’m finding this whole process very stressful ! I forgot to say my husband is 60 so don’t know if he is a similar age to your husband.

[Wiltymumma]

Rachel thank you for your input, I know there are a lot of things it could be before ALS so I’m keeping fingers crossed !

[Ellie]

Wiltymumma Has he had an EMG and nerve conduction study yet? x

[Wiltymumma]

Hi Ellie

Thank you for replying.
At the initial consultation the neurologist said the NCS/EMG would be the last thing he would do (and dependent on MRI) and he warned us that this was going to take some time to get a diagnosis. We are awaiting results of the MRI now. All the blood tests have come back clear.

On clinical examination there was clinical weakness although muscle wasting was not a major feature. My husband was given a foot drop splint by the physio and this is helpful but it evidently has shown him that it’s a real effort to move the whole leg not just stop the toe from dragging and scuffing,

[Ellie]

Wiltymumma Yes, muscle atrophy does not happen at the start, only after sustained function loss does muscle normally begin to waste. As Rachel says, there are a number of potential reasons for LMN & UMN symptoms, other than an MND.

If the MRI doesn't provide answers, I hope the next tests are the EMG & NCS and that the Neuro keeps you in the loop as to what's in and what's out.

Wishing you both good news.

Look after yourself.

Love Ellie.

[Wiltymumma]

Hi Ellie
Thank you for the clarification with regards wasting. hopefully we will get some answers from the MRI soon.

i wish you all the best and really appreciate you taking the time to reply.

[matthew55]

Thinking about it my thighs have shrunk but not my calf muscles. Many New Disasters 😁x

[Wiltymumma]

Hi Matthew thank you for your message it is much appreciated. I have read previously that the quads can waste by as much as 20% if a person is off their feet by just 2 to 3 weeks I.e even without MND. I guess when we are well we just don’t realise how well we work !