COUPLE MAKE THE BEST OF ALS AS RESEARCH CONTINUES

ALS currently affects about 100 people on Cape Cod, about 400 people statewide and about 30,000 in the U.S. The disease destroys the nerve cells that control muscles, ultimately causing complete paralysis while leaving mental function intact, according to Dr. Drasko Simovic…

Typically the initial weakness affects the arms more than the legs, which is then followed with difficulties swallowing and speech dysfunction, he said. Death usually results from respiratory failure, he added…

The diagnosis of ALS is a “rule-out” procedure. There is no simple blood test for the disease. People who are suspected of having ALS are generally put through a series of tests to rule out other neurological conditions like multiple sclerosis, strokes or even carpal tunnel syndrome, said Dr. Simovic…

An electromyogram, which measures the signals that run between nerves and muscles and the electrical activity inside muscles, is used when doctors suspect ALS. A final diagnosis is the result of the tests, the patient’s medical history, and physician’s examination, according to Dr. Simovic…Scientists still do not know what causes ALS, but there are some suspects, said Dr. Simovic. “Most likely the disease is caused by genetic susceptibility combined with, for now, unknown environmental factors.”

Only one drug, riluzole, has been found to be somewhat effective against the disease, said Dr. Simovic. It may increase survival by three months, but has no effect on strength, respiration or quality of life, he said…The process of finding a cure “will be a length tedious one,” said Dr. Simovic. “But, many investigative efforts are being made all around the world.”

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Medical illustrations on this website are attributed to: Freepik.com and author Kjpargeter

Lateral Femoral Cutaneous Nerve

From: www.wheelessonline.com 

– Anatomy:    

– LFCN, as its name suggests, is purely sensory;    
– it arises from L2 and L3, travels downward lateral to the psoas muscle, crosses the iliacus muscle (deep to fascia), passes either thru or underneath the lateral aspect of the inguinal ligament, and finally travels onto innervate the lateral thigh;
– it divides into anterior and posterior branches and supplies skin on lateral aspect of thigh;
– in the study by Hospodar et al (JTO 1999), the course of the nerve was variable, but was most commonly found at 10-15 mm from the ASIS and as far medially as 46 mm from the ASIS;
– in no specimen did the nerve pass lateral to the ASIS (eventhough historically the nerve is thought to pass lateral to the ASIS in 10% of population);
– in all specimens the nerve passed underneath the ilioginal ligament and anterior to the iliacus muscle; 

– Meralgia Paresthetica: 

– entrapment syndrome of the lateral femoral cutaneous nerve causing burning, numbness, and paresthesias down the proximal-lateral aspect of the thigh;
– may be idiopathic, be a result of trauma, previous operations, and in some cases may arise from Perthes Disease abduction splints;
– in idiopathic cases, the nerve may be encased in bone by the growing apophysis of the anterior superior iliac spine, or may be entrapped in fascia either proximal or distal to the ASIS;    
– diagnosis is made by:           
– reproduction of the pain by deep palpation just below the anterior superior iliac spine and by hip extension;           
– relief of pain by localized injection of lidocaine;    
– treatment: when diagnosis is not in doubt and the symptoms are severe, consider operative decompression at the site of constriction;

EMG and NCS

Electromyography (EMG) and nerve conduction studies (NCS) are tests that measure the electrical activity of muscles and nerves. Nerves send out electrical signals to make your muscles react in certain ways. Nerves also send signals from your skin to your brain, which then processes the signals, so you can experience a variety of skin sensations.

  • An EMG Test looks at the electrical signals your muscles make when they are at rest and when they are being used.
  • A Nerve Conduction Study measures how fast and how well the body’s electrical signals travel along your nerves. EMG and nerve conduction studies are used to help diagnose a variety of muscle and nerve disorders and to quantify the severity of your condition.


An EMG test helps find out if muscles are responding the right way to nerve signals. Nerve conduction studies help diagnose nerve damage or disease. When EMG tests and nerve conduction studies are done together, they help doctors tell if your symptoms are caused by a muscle disorder or a nerve problem. With EMG and NCS studies, your doctor can next select the best therapeutic option to help you.