ALS?

[SouthernBlueBelle]

Hello.

My father-in-law was recently diagnosed with ALS.  Of course we all do not want this to be true, but I am truly skeptical.  He is now 50 as of this year.  Here is a little history that may have some affect:
In the 1970's he was hit over the head with a steel pipe & had brain surgery.
Shortly after that he developed a large fat deposit at the base of his neck on his back.  Doctors have always dismissed this as a "fatty tumor" or other things.  I have recently done some research & realized this is what they call "Lipodystrophy."  This can be a symptom of several other conditions.  Recently he has acquired some new fat deposits in his neck area & around the collar bone.  

Also, about 2 years ago he suffered a heart attack.  Shortly after the heart attack is when he started noticing his legs not working quite right.  He eventually started dragging his feet somewhat & now walks with a cain & has alot of trouble.  It has gotten much worse over time, but recently they did diagnose him with ALS with ONE test.  I believe that they may have just "thrown" out this diagnosis b/c he does not have health insurance.

Also, around the same time the symptoms showed up he quit smoking (b/c of heart attack) & he drinks alcohol on a regular basis.

Before the ALS diagnosis they said they found atrophy in his brain in the area where the surgery in the 70's occured.  Also, he is in alot of pain & has a heightened sensitivity in his feet & has swelling in his legs & feet.  He has also put on a good bit of weight.

Any clue of what else we could have him tested for?
We just did a test for cortisol levels for Cushings.  I suggested a diabetes test.  Any other suggestions?

Thanks,
Bethany

[SouthernBlueBelle]

Thank you SO much!  :)

[PaulMD]

Hi there.

Other explanations for his pains and weakness of the feet would include vascular problems such as arterial occlusive diseases.  The mechanism behind this may be similar to what provoked the heart attack which is arterial occlusion as well. This may be diagnosed with angiography, whether classical or magnetic resonance (MRA).  Alcohol may deplete the body of micronutrients such as vitamin B, and this may cause neurologic symptoms such as weakness and pain.  Evaluation of vitamin B levels may help in assessing this, and treatment may include supplementation and alcohol avoidance.  These are some things to discuss with your doctors.

Regards and God bless.