How to detect early signs of MS or ALS?

Question

Hi doctor,

Since few months, I have had leg weakness, but they are not actually weak. They just feel like it. And also feels heavy sometimes. I also have slight shakiness in hands and shooting pains in my left knee. The cardiology checkup was normal, CT scan done a month ago was normal except for an arachnoid cyst. Also, I feel light-headed sometimes and off balance sometimes. I am worried about it either being MS - multiple sclerosis or, more likely, ALS - Amyotrophic lateral sclerosis. My cousin died in January from ALS - amyotrophic lateral sclerosis. His disease progression was rapid. I am 48 years old.

Please advise.

Answer 1

Hello,

Welcome to icliniq.com.

I would like to know some details about your symptoms:

1. since when do you have the symptoms? How long was the duration? Was it of sudden onset or developed slowly over time?

2. How exactly do you feel in your legs? What activities seem difficult with legs - getting up from sitting or walking or putting the foot in footwear or burning or tingling in the leg or anything else? Please describe.

3. Do you notice any thinning of muscles in the leg or any limb?

4. Do you have any back pain?

5. What kind of pain do you have in the left knee? Is it particularly in the knee joint or the leg? Does it feel like an electric shock- like sensation, burning, or something else?

6. Have you ever got a clinical examination done by a neurologist?

The treatment plan includes the following:

Revert with the above-mentioned information for better understanding and further judgment.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

Multiple sclerosis usually presents acutely, not gradually (except primary progressive multiple sclerosis variant, which can start gradually). Amyotrophic lateral sclerosis starts gradually. Symptoms are weakness in muscle power and thinning (atrophy) of muscles of the limb. But you are denying any particular weakness or thinning of muscles & also say reflexes are normal. In this scenario, your symptoms are not clearly favoring Amyotrophic lateral sclerosis. But there is no specific test to rule out Amyotrophic lateral sclerosis, as it is diagnosed based on clinical criteria after ruling out other causes of symptoms. For multiple sclerosis, magnetic resonance imaging of Brain & whole spine can be done. If no Multiple sclerosis-like lesions are found, we can say that it is not Multiple sclerosis (as of now). These tests also do not predict the future risk of developing Multiple sclerosis or Amyotrophic lateral sclerosis.

Thank you.