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      Re: Re: ALS vs MG

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Posted by CCF Neuro MD on August 12, 1997 at 21:30:31:

In Reply to: Re: ALS vs MG posted by L Wilson on August 11, 1997 at 18:07:26:

: Hi,
  I have MG. The tensilon test would be effective if he has MG. I don't know
  about ALS. There are other test that work well on MG. One test is the EMG.
  I had a friend who was diagnosed with MG the same year (94) as I, He went
  to a second Dr. and was diagnosed correctly with ALS. The two diseases
  start off simarilly(sp) and end up much different within 6 months.
  Hope this helps, I will be in Tucson on Labor day, drop a line if you would
  like to talk with me. ***@****
  L Wilson
  : My father in law (64)  is currently having difficulty speaking and swallowing that has been evident for 6 months.  He is currently seeing doctors of the Neurology Clinic at UMC in Tucson.  To date he has been told this could be ALS or MG. Today he was in for Pulmanry testing and the muscle testing.  After muscle testing, his doctor mentioned today that they will plan the transfusion therapy within 3 months.
  : Physically, he seems pretty much the same - able to walk daily, yardwork, etc...
  : Is there any test that can be done that would identify this as MG or ALS?
  : I have read about the Tensilon test.  Would this be useful in the diagnosis?
  : He has not had this test as his current Neurologist has stated since he has all the symptoms of ALS and all the symptons of MG it would be useless.  Should we get a second opinion?  Wondering what it is?
  : Thanks in advance  -  
Dear Ed:
Although ALS and Myasthenia Gravis are very different disorders, they do have quite a few symptoms in common, such as diffuse muscle weakness, difficulty with swallowing and speaking, neck weakness, shortness of breath, and lack of sensory involvement. An important differentiating feature is the occurrence of eye muscle weakness and droopy eyelids in frequently but not universally in MG (these signs are almost unknown in ALS early on). Other features are the relative preservation of muscle bulk in MG, and the presence of spasticity in ALS, but these are not invariable. Although it is not common, we do see occasional cases in whom it is difficult to diagnose MG/ALS. The Tensilon test is highly subjective with false-positive and false-negative cases, and may not be very useful in your father-in-law
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