Sensory Symptoms in Amyotrophic Lateral Sclerosis

ABSTRACT

Objective & BACKGROUND: It has been recognized that sensory symptom is one of the important exclusion criteria for diagnosis of ALS. However, sensory symptoms are occasionally complained of by some patients with ALS and there have been several reports on pathologic evidence of degeneration in sensory pathways. Therefore the authors performed the study to evaluate the sensory symptoms in patients with ALS and to analyze the cause of sensory abnormalities. Method: The clinical and laboratory data of seventy-seven ALS patients were obtained including history, neurologic examination, cervical magnetic resonance imaging, and electrophysiologic study. We evaluated the nature of subjective sensory symptoms and analyzed underlying causes for these abnormalities. Result: The onset age of 77 patients was between 19 and 75 years(mean age=49.5).. Twenty-five of 77 subjects (32.5%) complained of sensory symptoms such as paresthesia and tingling sensation. On neurologic examination Four patients (5.2%) had objective sensory change such as hypesthesia, decreased vibration sense. Five of 25 patients with sensory symptoms had superimposed underlying disease cervical radiculopathy in 4, peripheral neuropathy in 1. Four of 37 patients showed central conduction defect on sensory evoked potential studies. Therefore in some patients, abnormalities in central sensory pathways are thought to be responsible for their sensory symptoms. Conclusion: The patients with ALS may have sensory abnormality although objective findings are rarely noted. Therefore coexistence of sensory symptoms does not exclude ALS. The presence of cervical radiculopathy, peripheral neuropathy and degeneration on central sensory pathways were thought to be the possible causes of their sensory symptoms.