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Dr. Frank
Dr. Frank, Board Certified Physician
Category: Neurology
Satisfied Customers: 7201
Experience:  Board certified general Adult Neurologist, with experience in experimental neuroimaging and neurodiagnostics.
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I have dysarthria and want to go for more diagnostic evaluation.

Customer Question

I have dysarthria and want to go for more diagnostic evaluation. I have been tested for. ALS, MS, MG, brain tumors, and all were negative. I also have night leg cramps, and twitches all over my body.
Where is the best clinic or medical facility to go for further evaluation and diagnosis?
Submitted: 1 year ago.
Category: Neurology
Expert:  Dr. Frank replied 1 year ago.

Customer:

Hello

Customer:

welcome to Just Answer

Customer:

where are you located?

Customer:

I am waiting for you to come online

Customer:

as you are offline, please get back to me and I can suggest a location from more evaluation

Customer:

Dr Frank T

Expert:  Dr. Frank replied 1 year ago.
Our chat has ended, but you can still continue to ask me questions here until you are satisfied with your answer. Come back to this page to view our conversation and any other new information.

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If you haven’t already done so, please rate your answer above. Or, you can reply to me using the box below.
Customer: replied 1 year ago.
I live in Colorado Springs, but I am willing to go anywhere in the USA for a good diagnosis.
Customer: replied 1 year ago.
I must leave for 2 hrs, but you can send a message to my email address XXX@XXXXXX.XXX

I do not text
Expert:  Dr. Frank replied 1 year ago.
Hello. I cannot send an email as it is out for confidentiality reasons. You can go to customer service, and they can email you a copy. From this information, and given the analysis to date, I would focus on the dysarthria as a symptom to evaluate, there are some conditions that are language based, where you can then develop fasciculations or twitching in the body, it can be neurochemically mediated by dopamine depletion. The most famous investigator of this problem in the US is Dr.Muslim in Chicago at Northwestern Univ. Medical center. here is his contact information. I would suggest you contact his office, send it the clinical files for his review, and he will see about an admission for evaluation of the language dysfunction. There is a condition called Pure progressive aphasia (PPA)
http://www.neurology.northwestern.edu/faculty/mausoleum.html
Alternatively, you might consider a visit to the Mayo Clinic in Scottsdale Arizona, but get back to me to discuss that further if interested, or rate my service if you can and are satisfied. Dr Frank T
Customer: replied 1 year ago.
This all started a year ago with the leg cramps, then 3 weeks later the fasciculations, then problems speaking started very slowly. I noticed at that time that my breathing had changed, and was very shallow.
The first EMG For ALS was July 9, just a as I was headed to the hospital for extensive colorectal surgeries. After 8 surgeries, 5 units of blood and almost dying, getting an osteomy bag I went back home again and remembered that when on Oxygen, my fasciculations stopped. Since then I use deep breathing to stop the twitches.
The speech and swallowing have progressed and neurontin seems to help. I sure can tell when it is wearing off. Mayo is on my list of possibilities, is there any better place?
I am frustrated that my neurologist here is just waiting to see what develops next. I want more answers!
Thanks, Joy
Expert:  Dr. Frank replied 1 year ago.
some of these progressive aphasias or dysarthrias have been associated with ALS like symptoms, so that is the way I was headed in this diagnosis, but if the EMG is not supportive, and that can happen in these ALS like syndromes, then you proceed to further evaluate the language dysfunction. One way is with fMRI scanning. That is functional MRI scanning, which means you focus on changes in brain oxygenation in the MRI scanner, so they put you in the scanner with virtual reality goggles, and you have to speak, and they record your brains ability to work your mouth, so to speak, how it is doing, compared to "normal" control subjects. So the Mayo, they would do that, or in Chicago probably as well. I would ask your doc if you could have PPA-ALS complex . The Mayo is great for a few reasons, it is set up to handle out of town visitors, and makes the trip a non-hassle experience, everything is really well organized, so you don't sit around waiting to see a doc, it follows a strict schedule, your entire day, so you are evaluated and tested all in one day outpatient if that is appropriate.
You would have to have your neurologist write a letter of necessity or consult to send to them as part if their pre-screening. But that might be the most practical solution. Please get back to me if you have further questions or rate my service if you can .DR Frank T
Dr. Frank, Board Certified Physician
Category: Neurology
Satisfied Customers: 7201
Experience: Board certified general Adult Neurologist, with experience in experimental neuroimaging and neurodiagnostics.
Dr. Frank and 2 other Neurology Specialists are ready to help you
Customer: replied 1 year ago.
Are there any other clinics which might be able to help me? Mayo in AZ does not have the specialists I would need.

Thanks, Joy
Expert:  Dr. Frank replied 1 year ago.

Did you check with Dr Mesulam at the Univ of Chicago? I will attach the website. Another place to consider is Barrows Neurological Institute in Phoenix. I will attach their website. Dr Frank t http://www.neurology.northwestern.edu/faculty/mesulam.html http://www.thebarrow.org/Neurological_Services/index.htm

 

 

If you can go anywhere, you really need the expert in language dysfunction, and that would be Chicago

 

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