20 March 2008
The neurologist wrote to Professor Leigh, at Kings College Hospital, and said inter alia:
“My 15th February examination revealed widespread fasciculation’s, bilaterally in the upper body and in the thigh, but to a lesser extent.
His neorophysiology demonstrated widespread ongoing denervation with fasciculations including the axial muscles. I have subsequently discussed the findings with (a colleague) who confirmed the findings. Whilst the most likely diagnosis is motor neurone disease, I recommended found the investigations to exclude other diagnoses
On cranial nerve examination, the palate moved freely. There was no fasciculations of the tongue. Time strength was intact. There was no evidence of any bulbar abnormality. His neck flexion was 5/5.
He has wasting also need deltoids bilaturally and on the left biceps and triceps and to a lesser degree muscles of the left forearm. On examination, he had weakness of shoulder abduction,4 on the left, 4+ on the right. The right arm was otherwise normal with the left arm grade 4 triceps and biceps the left hand was globally 4 again. Infraspinatus and supraspinatus were 4 on the left. Reflexes are+ throughout. Sensation is intact. In the lower limbs, there was a hint of weakness of left hip flexion. The rest of the appeared intact. Reflexes were present in, the knees, absent in the ankles. Plantars were going down. There was a reduction in vibration on the right to the ankle but intact to the left. Pinprick was intact. Chest examination was normal with good diaphragmatic movements. Abdominal examination was unremarkable and there was no hepatomegaly.”
It was as a result of this that I had the MRI scan, the lumbar puncture and blood tests.
The neurologist concluded his letter to Professor Leigh by recording that he had seen me and Alice on the 21st February and confirmed his belief that the diagnosis of Motor Neurone Disease was firm.