What are the symptoms of myasthenic lateral sclerosis

Myasthenic lateral sclerosis is a type of myasthenia gravis. This disease is relatively rare in life, but the incidence rate is still certain in the world. The motor nerve cells of patients with this disease are damaged, causing local and whole-body muscle weakness, atrophy, and finally paralysis.

Amyotrophic lateral sclerosis (ALS), commonly known as "Lou Gehrig's disease", can affect upper motor neurons (brain, brainstem, spinal cord) or lower motor neurons (cranial nerve nuclei, anterior horn cells of the spinal cord). Also called motor neurone disease (MND), Charcot disease in France and Lou Gehrig's disease in the United States. In my country, amyotrophic lateral sclerosis and motor neuron disease are often used interchangeably. It usually occurs in patients aged 30 to 50 years old, and is characterized by peripheral paralysis of the upper limbs, central paralysis of the lower limbs, and mixed and symmetrical damage to the upper and lower motor neurons.

Early symptoms of amyotrophic lateral sclerosis

Asymmetric muscle weakness in the hands: The earliest symptom in patients with amyotrophic lateral sclerosis is usually asymmetric muscle weakness in the hands, such as inflexibility in hand movements such as buttoning, opening doors with keys, and decreased grip strength. ALS progresses slowly, but the patient's hand weakness becomes increasingly obvious, and small muscle atrophy occurs, especially in the thenar and hypothenar muscles, interosseous muscles, and lumbrical muscles, and gradually extends to the forearm, upper arm, and shoulder girdle muscles. A twitching sensation in the area of ​​muscular atrophy. The symptoms progressively worsen, and the lower limbs also feel weak, stiff, and uncoordinated, with foot drop when walking, but muscle atrophy is not obvious. Physical examination showed muscle atrophy and weakness in both upper limbs, which was more severe in the distal end than in the proximal end, and some patients presented with "eagle claw hands". Obvious fasciculations can be seen in atrophic muscles. The muscle tension is not high, but the tendon reflexes are hyperactive and the Hoffman sign is positive. Spastic paralysis of both lower limbs, high muscle tone, hyperreflexia of tendon, and positive pathological reflexes. Objective examinations of the sensory system show no abnormalities, but patients often have subjective sensory symptoms such as numbness and coldness.

Early symptoms of amyotrophic lateral sclerosis

Tongue muscle atrophy and fibrillation: In the early stages of amyotrophic lateral sclerosis, tongue muscle atrophy and fibrillation are more obvious and may even be the first symptoms. As the disease progresses, ALS muscle weakness and atrophy spread to the trunk, neck, and finally to the facial muscles and medullary innervated muscles, manifesting as slurred articulation, dysphagia, and chewing weakness. However, due to damage to the bilateral corticobulbar tracts, dysphonia and dysphagia can be caused by pseudobulbar palsy. Among the facial muscles, the orbicularis oris muscle is most obviously affected, while the extraocular muscles are generally not affected. There is usually no sphincter dysfunction, and consciousness is not affected.