Could These Symptoms Indicate Amyotrophic Lateral Sclerosis?

Are these the symptoms of amyotrophic lateral sclerosis (ALS)?

Last year, I experienced numbness in my left little toe, and sometimes it felt like there was no sensation when I touched it.
I visited a neurologist, who mentioned that there was some inflammation in my calf, but I can't remember the details.
Yesterday, I accidentally touched a spot on the front of my shin bone that felt indented, and I wondered if there was a problem.
I went to the hospital for an X-ray, which showed that the bone was fine.
The doctor suggested that the indented area might indicate some muscle atrophy, possibly related to the previous numbness in my toe, and recommended that I see a neurologist for further evaluation.
I run for an hour every day and sometimes walk long distances, but I only feel pain in the soles of my feet; my calves don't feel uncomfortable, and I don't experience any weakness in my calves.
I'm quite worried and would like to know if this could be a symptom of amyotrophic lateral sclerosis (ALS).

Tuo Er, 30~39 year old female. Ask Date: 2011/09/04

Dr. Lan Shengxing reply Neurology

Hello Tor, the symptoms you described are different from those of amyotrophic lateral sclerosis (ALS).
ALS is a motor neuron disease that primarily affects the motor neurons in the central nervous system, and it typically does not cause issues with sensory nerves.
In other words, the tingling sensation you mentioned is not characteristic of motor neuron diseases.
The symptoms you described are more likely related to peripheral nervous system issues.
If the tingling in your toes and subsequent muscle atrophy occur in the same area innervated by a specific peripheral nerve, then it is likely a problem with that nerve.
The underlying cause would need to be determined through a detailed clinical examination.

Reply Date: 2011/09/04

More Info

The symptoms you are experiencing, such as numbness in your left toe and the recent discovery of a dent in your calf muscle, can understandably raise concerns about conditions like Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig's disease. However, it is essential to approach this situation with a comprehensive understanding of ALS and its symptoms.

ALS is a progressive neurodegenerative disease that primarily affects motor neurons, which are responsible for controlling voluntary muscle movements. The hallmark symptoms of ALS include muscle weakness, muscle atrophy, and fasciculations (muscle twitching). Patients may initially notice weakness in their hands or feet, difficulty speaking, swallowing, or breathing, and a gradual loss of muscle control. Sensory symptoms, such as numbness or tingling, are not typical in ALS, as the disease primarily affects motor neurons rather than sensory pathways.

In your case, the numbness in your toe and the muscle atrophy in your calf could be indicative of several other conditions that are not related to ALS. For instance, peripheral neuropathy, which can result from various factors such as diabetes, vitamin deficiencies, or nerve compression, could explain the numbness. Additionally, localized muscle atrophy may occur due to disuse or injury rather than a neurodegenerative process.

Given that you have been active in running and walking, it is also possible that your symptoms are related to overuse or strain, which can lead to inflammation or muscle fatigue. The fact that you do not experience weakness in your calf and only have discomfort in your foot suggests that the issue may not be related to a severe neurological condition.

To further evaluate your symptoms, it is advisable to follow up with a neurologist, as they can perform a thorough clinical examination and may recommend additional tests, such as electromyography (EMG) and nerve conduction studies. These tests can help assess the function of your motor neurons and determine if there is any underlying neuropathy or other neuromuscular disorders.

In summary, while your symptoms may cause concern, they do not definitively indicate ALS. It is crucial to seek further evaluation from a healthcare professional who can provide a proper diagnosis based on a comprehensive assessment of your symptoms and medical history. Early intervention and accurate diagnosis are key to managing any potential underlying conditions effectively. Remember, many conditions can mimic the symptoms of ALS, and a thorough investigation is necessary to rule out other possibilities.

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