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Postby guest on January 6th, 2003, 1:09 pm

hello all.

1. there seems to be a generally held view on the site that 'a good neurologist can spot an als as soon as he walks into a room'. Can it really be that obvious? What if the patient only had a slight weakness in the hand for instance, Surely this couldn't be detected by sight?

2. I'm surprised at how many folks declare that they've twitched for 12 months plus and still are concerned about als. Surely by this type of time it would be wholy apparent if the disease was going to manifest or not?

Best wishes to you all and a happy new year.
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Postby DogBone on January 6th, 2003, 1:19 pm

I believe that when they say "walk in the door" they mean after and neurological exam. They check your strength, especially in the areas about which you complain. And they test all your reflexes and they look for other signs like Babinski. So I guess they should say that a good neurologist can tell ALS when you walk out the door. :lol:

The problem is - we here with BFS have a hard time believing the people who study these things all their lives.
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Postby Arron on January 7th, 2003, 12:16 am

The deal with neuro's saying they can usually spot a true ALS case the minute it walks through the door is becaue most people with ALS don't even notice the twitches. An ALS twitch is very fine compared to BFS twitches. A true "fasciculation" is a very fine, low impulse, momentary twitch that barely has enough power to move the surface of the skin and you have to figure that if the twitch is caused by dying nerves and muscle tissue, you most likely wouldn't feel the twitches happening in the first place... after all, if your muscle is dying and the nerves are disconnecting, then what is sending the signals of "feeling" the ALS twitch up to the brain? Not much, that's for sure... it's pretty hard to send signals of "feeling" through dead or disconnected nerve endings...

So, with that, most people don't even notice the twitches with ALS and being that the twitches are a secondary reaction to the ALS process, by the time anyone has any symptoms that warrant seeing a doctor, it is pretty obvious to the doctor (by that time) what is going-on, hence... they can usually spot it the minute it walks through the door.

Most people have no clue about ALS, some have never even heard of it and most have no idea that ALS even causes twitches, so it isn't "normal" for someone to go see a specialized neuro over a small twitch unless there are other major symptoms going on as well that they feel needs a neuro's attention...

The answer to your other question is Yes, after 12 months with no weakness or atrophy, one could rest much easier at night knowing that the chances of something bad being the cause are pretty much ruled-out by then.
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Postby guest on January 7th, 2003, 3:18 am

Thanks both for taking the time to reply to that lads.
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