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Demyelination disorder of the CNS - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Brain and Spine
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2572 Questions
User :   I have muscle twitches in my left shoulder and tricep and sometimes in my right tricep. this all started two months ago after catching a 250 pound man on a stretcher. I have no pain just loss of grip strength in my left hand in the morning which goes away in a couple of hours. I had a mri done and it reveled a partial tear within the infraspinatus muscle and a supraspinatus tendinosis but no high grade partial or full thickness tear. C5-C6 right 3mm paracentral protrusion and 2mm left paracentral protrusion at C6 and C7. Nuro- Doc says i dont have ALS and he dosent think the protrusions are causing the muscle twitches that go on 24-7. He did order a EMG test next week to confirm that it is not caused by the protrusions. I am 30 years old with no medical problems. What do u think.
Doctor :   Hi
Doctor :   Let me read the query.
User :   hi
Doctor :   Do you have pain in your neck/spine?
User :   no
Doctor :   Have you had similar problems in the past?
User :   And i also passed all of his test really well he said for strength. no
Doctor :   Ok
User :   this all started a day after the accident
Doctor :   Do you feel your muscles on the left upper limb when compared to the other has reduced bulk?
Doctor :   I mean do you feel that the muscles are wasted on the left upper limb?
User :   no not at all there smaller than the right but im right handed and they look the same as always
Doctor :   Ok
Doctor :   Let me explain to you.
User :   ok
Doctor :   ALS is characterised by muscle wastings.
Doctor :   In the absence of muscle wasting, I do not feel that your symptoms are associated with ALS.
User :   so what do you think
User :   and could you tell if your muscle was wasting away in two months
Doctor :   Muscle wasting are usually feature of long standing problem,
Doctor :   however muscle wasting is one of the early features of ALS.
Doctor :   So I do not feel your symptoms may be due to ALS.
Doctor :   Based on your description,
Doctor :   I can think of few possibilities that can be the cause
Doctor :   11
User :   whats 11
Doctor :   1. Symptoms could be a function one, probably secondary to anxiety
Doctor :   2. Cervical disc protrussion with secondary nerve compressions.
Doctor :   This can be excluded by EMG studies
Doctor :   3. A demyelination disorder of the CNS
Doctor :   These are the 3 possible causes that can explain your symptoms
Doctor :   Without a physical examination and evaluatio
Doctor :   I cannot predict exactly which among this is the likely cause.
Doctor :   The first is the most likely one.
Doctor :   However, I suggest you to wait for the reports of EMG, and things will be clearer after the reports.
Doctor :   Have you followed what I have suggested?
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