NEURO410 Lecture Notes - Lecture 20: Amyotrophic Lateral Sclerosis, Motor Neuron Disease, Medulla Oblongata
12 Oct 2016
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Lecture 9: motor neuron disease (clinical aspects) march 22/16. A 53 yo man noticed progressive clumsiness in his right hand. He had difficulty writing and buttoning his shirt. He was reassured by a dr that he prob had a pinched nerve in his neck. 6 months later he was unsteady when walking and was liable to trip. On exam he had wasting and weakness of hand muscles (right worse than left). The legs were spastic and reflexes were increased in the legs. Mri cervical spine = normal (b/c thought he had pinched nerve in neck) Electromyography: active lower motor neuron disease in arms and legs. Als was diagnosed: 9 months after his initial symptoms. 3 months later his speech slurred and he started coughing when eating/drinking. Physiotherapy and analgesics were required to control shoulder pain. 2 years after symptoms began, was restricted to a wheelchair with no functional strength remaining in arms.
