Can ALS be Diagnosed with MRI?

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SammusLee

New member
Can anybody please tell me if this is possible ALS? I had an MRI of the cervical spine done and was told I have a herniated C5-C6 disk. I was having fatigue in my legs and arms at the time and pain in the back of my neck. I went to see a neurologist who noticed no weakness upon examination but did see brisk reflexes in my arms. He did an EMG where the end impression read: Abnormal study showing evidence of acute denervation in bilateral C7 nerve roots. Please tell me what this means and if this could possibly mean ALS? I also received a copy of the EMG results and noticed here was a 1+ Fib and PSW in my left radial Triceps at C6-7-8. In addition, the paraspinal portion of my EMG showed my Right CervPara Low, Rami Nerve at Root C7-C8-T1 was noted as Inc under the Ins. Act. column. Lastly, the Left CervPara Low result was the same. Please tell me what all of this means. I am having twitching all over, weakness in legs and arms and am scared to death. I have 2 young children and need to know if his impression can mean possible ALS.

Thank you.

:crying:
 
LeeWee,

Fibs are not just found in neurogenic disease. Let me ask you a few questions please. What did your Dr. say during exam, did he seemed concerned? Did your MRI show that your discs were pressing on spinal cord, which can happen? You mention you had no weakness during exam, so when did the weakness start, how long after the exam? What was your number for the reflexes that were brisk? How long has the twitches been? Did they start before or after the weakness? Did your Dr. give you results of the EMG, if so what was dx?

I know honey this must be so scarry, I have to go get my EMG done on Monday to hon but have been dx with BFS. Listen please dont have yourself dieing, the mind is powerful. Stay with us and pour out your anxiety on this forumn we will be here to talk with you.

If you could reply back and answer my questions and I will keep
checking for your reply all night if I have to, promise. God Bless you..Jenn
 
Jenn. God Bless you for answering me so quickly. This is an amazing website ... I cannot believe the amount of people out there suffering. It is sad, but comforting to know I am not alone.

I'll try and be as brief as possible about how this has come about. About 3 months ago, I was getting discomfort in my neck and felt like I was having trouble swallowing. I went to an ENT who did a soft tissue neck MRI which picked up the disc herniation. He referred me to a neurologist who sent me to a surgeon who wanted to operate without considering any conservative measures (i.e., steroids, physical therapy, etc.). At this point, I did alot of reading about cervical disc herniations and couldn't find too much information relating it to bodywide twitching and muscle fatigue. But you can imagine what I did find in my research!

So ... I questioned both the neurologist and the surgeon and neither one could explain the bodywide muscle twtiches. they also couldn't explain the weak feeling and fatigue in my legs. They said the weakness in my arms made sense from the disc but not the legs.

Walking up the stairs is exhausting, my arch in my right foot hurts and cramps up and my legs just feel weird (like jello). I also have this kind fatigue in both arms. One point I'd like to make is that all symptoms worsen with exertion.

So ... I went to another neurologist (like I am sure EVERYONE in this forum has done) for a second opinion. This doctor said I wasn't exhibiting any weakness during the clinical exam (i.e., pushing on my arms, walking on toes, heels, etc.). However, he did note the brisk reflexes in my arms but didn't give me a number. He felt that this was due to the disc compressing the spinal cord. He then prescribed a 2 week course of steroids which didn't help.

At my 2 week follow up visit, I was nosy and when the doctor left the room I read the inside of my chart and saw he had written down a possible diagnosis of ALS or BFS. As you can imagine, I completely freaked out. When I questioned him, he calmed me down and said he had to put it down as a possibility because of the twitching but it was highly unlikely due to the way my symptoms were presenting. He again stated he thought it was the disc but now my mind was off and running. I went to high school with a guy who died from ALS and it was just plain awful to see.

He then prescribed Clonazepam for my anxiety but it made me so exhausted I couldn't function during the day.

In a nutshell, my MRI did show that my disc is pressing on the spinal cord but nobody can explain why I am getting weakness in my lower extremeties, as this is not normal with cervical disc compression from what I have read. And nobody can explain the bodywide twitching (even in the face).

To answer your other questions, the fatigue and/or weakness was present during both neurological exams, but it was my complaint ... neither dr. noticed it during the clinical exams. The surgeon said he noticed weakness during his clinical exam in my right bicep but he was so quick to want to operate, I don't know how much I trusted his opinion.

Also ... the twitches started after the weakness. And lastly, he did give the EMG results but there was no diagnosis written ... He just wrote that there was acute dennervation in the C7 nerve root. He wants to see me again in 2 months. I take this to mean he wants to see if any weakness presents itself but I am too embarassed to ask him why 2 months at this point.

I am so sorry for the long-winded post but I just wanted to make sure I answered your questions. Again ... thank you so much for caring enough to reply so fast. I am so scared and just wish it would stop. If it is BFS, I know I can live with it and I will move on. I am just so early in this process that the dreaded ALS is still a possibility in my mind.

Thank you so, so much for listening. I appreciate it more than you could know.

Lisa
 
LeeWee,

Ok you could have a couple of things going on here. First I dont know what Dr. you are seeing but a spinal Cord compression can to make your legs week, my neuro surgeon told me so. Think about that..people that have spinal cord injuries can be paralyzed from neck down. It is your spinal cord it travels all down the spine. If you have a nerve root compression yes it can. You see I had back surgery on three ruptured disks and when I started with my BFS I went to see my Neuro surgeon who did my surgery. I was having a stiff neck, pain and all my other symptoms like weak legs and arms. He said before I send you to neurologist I want to do a cervical xray..I said yeah but that would not make legs weak from my neck,, he said sure can if on spinal cord.

I know with ALS you have read that weakness comes first before twitches, well guess what,,,my twitches came last. I had stiffness when walking upstairs, legs shake when I would bend over and stretch, tremors, internal vibrations and then the twitching. BFS people experience fatigue and weakness. If you will read this forumn you will see alot of weakness amongst other things. ALSO AND THIS IS A BIG ALSO..anxiety caused half of my weakness, I even had and have still a cogwheeling muscle(rigid). When I was reading your post I felt so bad for you I could not get it off my mind,,guess what happened to me..my legs started going weak, felt funny going upstairs..Meaning our minds are powerful and emotions will cause symptoms because of the BFS. I know that your EMG showed 1+ with waves ...First of all you have a cervical herination with spinal cord compression, EMG will show nerve compression especially in your arm with cervical. oh and I also had brisk reflexes on exam 3+ acutally, this is also normal with BFS. Are you having any pins and needles, numbness? Have you had any footdrops? You did not have clinical weakness only in your bicep which, yes, you should you have a nerve compression..Also you did not have any clinical weakness in your legs. They feel weak I think because of anxiety, which is normal and you will have this if you have BFS. Do you have atrophy? Can you do some squats or pushups? Try it...Also how old are you? About your throat, has the swallowing problems gone away? What did that feel like, your mouth that is? Listen reply back to me again hon..Please do notttt research any diseases on the internet, this is the worse thing to do, you can and will develop those symptoms on top of producing more anxiety...Post back to me and if you want you can always pm(private message) me if you really want to vent..My prayers are with you....Jenn..oh let me know about any pins and needle sensations or anything else you have....
 
Hi Lisa, I am Basso. I am now writing my eight-hundredth and something post, and I have heard and responded to your story many times. This is not to put you down, for I have no doubt that you are a unique and wonderful person. However, in regards to your bfs; which is what it certainly seems like to me, you are rather ordinary, and deliciously so at that. ;)

Personally, I wouldn't start worrying about C6's and 7's because they will make you feel all 6's and 7's. This kind of info only serves to muddy the waters, because you are well and not sick. Just my take on it.

Have you read BFS in Nutshell? It is one of the moderator's, Alonzo, magnum opus. He got pretty much every questions, in my opinion, right, and I think it will make you feel pretty confident that what you have is just regular garden variety bfs, with a dash of Lisa thrown in.

Sleep well tonight. You have two little miracles to attend you and...after all, you are going to live a very long life, might as well use some of it up with a little shut-eye.

Cheers,
Basso
 
LeeWee

I would get your C6 and C7 checked if your DR. was even thinking about surgery. I am not saying go right out and get surgery because I did on my back and I wish I didnt...but yes, it could be causing weakness in your arms, known fact, and sometimes they just dont go away on there own.. If your Dr. said compression on spinal cord then ..ummm i would certainly look at that.. As far as you freaking out because you saw possible ALS on your chart, don't blame you, anyone would. I never heard of anyone on here having to deal with that and we have anxiety because we were told we have BFS ;) ..I am not saying freak out but what I am saying is I dont blame you for freaking out. I am sure you are ok but like I said before if you need to vent, my ears are open..God BLess..Jenn
 
I had "dents" in my elbows, too. Especially my left elbow. I totally thought I had the dreaded "A". However, after finally getting of the anxiety for a couple minutes and finally getting my feet underneath me, I realized I had "dents" in my left elbow because it was how I was putting my elbow down to type at work. The "dent" was the impression of my desk in my elbow.

I also have the normal dents and I have palpated every nook and cranny of my physical being...that's why I'm now on meds (Paxil) and getting therapy to address the health anxiety I have. And between both, it's starting to work.

I went about three to four weeks with very little twitching...it was awesome. But I got totally stressed the past few days because I had two lumps in my neck - and walla - BAM - twitches are back (especially in my right thigh...absolutely bouncing...). Well, because of these bumps, I then went down the lymphoma path. Well, guess what. The two "lumps" I had were the ends of the hyoid bone that we all have in our necks. :oops: Good stuff.

So, needless to say I'm doing everything possible to just relax and take it easy...the Paxil I just started and I think it actually does have a side effect of twitches, but I'm slowly getting used to them and once the anxiety simmers down, I'm guessing the twitches will too.

I'm sure your dents are normal dents. Just think of us as cars - eventually they'll throw us in the scrap yard, but before that happens, we're all going to get dents and dings. Part of doing business...

All the best and I hope you find this site helpful. I know I have.

AJ

So I'm doing everything I can to stop
 

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