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What is not?

 Impossible is not a fact, its an opinion 

Amyotropic lateral sclerosis

May 22, 2010 by drsalman

Case Sheet

A 40 year old male presenting to the office with progressive weakness ofleft hand.Weakness first began a couple of weeks ago when he was having difficulty in holding objects and making fists.Slowly his whole left arm became weak.Now he is also feeling weakness of right arm.He is also complaining of his stiff lower legs.

 On examination flaccid paralysis of left upper limb with Power 2/5 andflaccid paralysis of right upperlimb  with  power 4/5.Lower limbs shows spastic paralysis with power 4/5.Mild left wrist drop is also noted.

Case Discussion: 

MND 5 Main types

1.Amyotropic lateral sclerosis

2.Progressive Muscular Atropy

3.Primary lateral sclerosis

4.Progressive bulbar palsy

5.Pseudobulbar palsy

Rules: 

Weakness of one limb progressing to contralateral side 40

Flaccid paralysis of Upperlimb 50

Spastic paralysis of lower limb 50

Foot drop 30

Wrist drop 30

Ocular ivolvement -10

Bowel involvement -10

Respiratory involvement 10

CSF Increased proteins 10

EMG Denervation 50

If ALS then give Riluzole

If ALS hen give Supportive treatment

Questions: 

What is the diagnosis?

What is the best next step in managing this patient?

What are variants of MND??

Wht are types of MND??

Which test confirms diagnosis??

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