Reversible Motor Neuron Disease

Tsai, Ching-Piao; Ho, Hsu-Hua; Yen, Der‐Jen; Wang, Vinchi; Lin, Kong-Ping; Liao, Kwong‐Kum; Wu, Zin-An

doi:10.1159/000116977

Cited by 15 publications

(5 citation statements)

References 16 publications

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“…In fact, there are a few reports that ALS may be reversible, even without therapy [13][14][15]. The temporal association of the improvements with the therapy in the case of our patient, however, argues against spontaneous healing.…”

Section: Discussionmentioning

confidence: 51%

Healing of Amyotrophic Lateral Sclerosis: A Case Report

Mangelsdorf¹,

Walach

Mutter

2017

Complement Med Res

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Background: Amyotrophic lateral sclerosis (ALS) is a devastating disease leading to death within 3-5 years in most cases. New approaches to treating this disease are needed. Here, we report a successful therapy. Case Report: In a 49-year-old male patient suffering from muscle weakness and fasciculations, progressive muscular atrophy, a variant of ALS, was diagnosed after extensive examinations ruling out other diseases. Due to supposed mercury exposure from residual amalgam, the patient's teeth were restored. Then, the patient received sodium 2,3-dimercaptopropanesulfate (DMPS; overall 86 × 250 mg in 3 years) in combination with α-lipoic acid and followed by selenium. In addition, he took vitamins and micronutrients and kept a vegetarian diet. The excretion of metals was monitored in the urine. The success of the therapy was followed by scoring muscle weakness and fasciculations and finally by electromyography (EMG) of the affected muscles. First improvements occurred after the dental restorations. Two months after starting therapy with DMPS, the mercury level in the urine was increased (248.4 µg/g creatinine). After 1.5 years, EMG confirmed the absence of typical signs of ALS. In the course of 3 years, the patient recovered completely. Conclusions: The therapy described here is a promising approach to treating some kinds of motor neuron disease and merits further evaluation in rigorous trials.

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Section: Discussionmentioning

confidence: 51%

Healing of Amyotrophic Lateral Sclerosis: A Case Report

Mangelsdorf¹,

Walach

Mutter

2017

Complement Med Res

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“…In our opinion this patient met Awaji criteria for 'probable ALS' (17). Although spontaneous ALS reversals have been reported (18,19), these are very rare, and the temporal correlation between starting GFD and motor improvement here is impressive. Based on this, ALSUntangled assigns a 'Cases' grade of A (Table I).…”

Section: Data In Palssupporting

confidence: 54%

ALSUntangled No. 32: Gluten-free diet

2015

Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration

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“…Also, we do not intend to describe the clinical presentation as the motor neuron disease or amyotrophic lateral sclerosis but rather as motor neuron disease-like illness, since the patient's symptoms improved subsequently which does not fit in the classic description of motor neuron disease. However, reversible motor neuron disease has also been described in the literature [17].…”

Section: Discussionmentioning

confidence: 99%

Hybrid PET/MRI findings in a case of pulmonary and extra-pulmonary tuberculosis associated with motor-neuron disease-like illness—a coincidence or a causation?: a case report

Peer

Nagaraj

Mangalore

2021

Egypt J Radiol Nucl Med

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Background The association of tuberculosis and motor neuron disease-like illness has not been described previously. We present a case of co-existent pulmonary and extra-pulmonary tuberculosis in a young man whose clinical presentation was suggestive of a motor neuron disease-like illness and was subsequently diagnosed with tubercular infection. This case provokes our thought as to whether the association between tuberculosis and motor neuron dysfunction was just a co-incidence, given the high prevalence of tuberculosis in our set-up, or does it point towards a possible causative role of infection in motor neuron disease. Case presentation A 31-year-old man presented with progressive thinning of bilateral upper and lower limbs with associated pain and twitching sensation in upper and lower limb muscles. He had a history of loss of appetite and unintentional weight loss. On clinical examination, there was evidence of fasciculations in bilateral quadriceps, bilateral biceps, and paraspinal muscles which was further confirmed with electrophysiology. The work-up for underlying autoimmune, toxic and metabolic aetiology, and paraneoplastic aetiology was found to be negative. CT scan of the chest was suggestive of consolidations in bilateral upper lobes with multiple tree-in-bud nodules in both the lungs. Hybrid 18-Flourine-flourodeoxyglucose positron emission tomography and magnetic resonance imaging (F-18-FDG PET/MRI) imaging was also suggestive of pulmonary and extra-pulmonary tuberculosis. Imaging of the brain revealed atrophy along bilateral motor cortices with reduced tracer uptake. Diagnosis of tubercular infection was confirmed with nucleic acid amplification test and the patient was put on anti-tubercular therapy. On follow-up after 6 months, the patient reported improvement in the symptoms and the muscle power in bilateral upper and lower limbs. Conclusion We have described a very rare association of pulmonary and extra-pulmonary tuberculosis with motor neuron-like illness. It may be debated that such an association may just be co-incidental; however, given the improvement in the symptoms and signs of the motor neuron disease-like illness on follow-up while the patient was on anti-tubercular therapy, it may point towards a causative relationship between tubercular infection and motor neuron dysfunction. Further epidemiological studies should be sought for in order to reach a conclusive answer.

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Reversible Motor Neuron Disease

Cited by 15 publications

References 16 publications

Healing of Amyotrophic Lateral Sclerosis: A Case Report

Healing of Amyotrophic Lateral Sclerosis: A Case Report

ALSUntangled No. 32: Gluten-free diet

Hybrid PET/MRI findings in a case of pulmonary and extra-pulmonary tuberculosis associated with motor-neuron disease-like illness—a coincidence or a causation?: a case report

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