Severe progression of ALS/MND after intervertebral discectomy

We observed seven patients who developed their first signs and symptoms of motor neuron disease together with signs of protrusion/prolapse of interver tebral disc. The age of the patients was between 55 and 67, of which one fe male and six male patients. All of them suffered from cervical spine pain o r low back pain. The female patient and one male patient developed weakness in the small feet muscles as initial symptom and they complained of parest hesia along dermatomes L5S1 and of severe pain. The other five patients dev eloped wasting of the hands muscles. They had a rather mild pain in the cer vical spine and early morning paresthesia as well as severe causalgia along dermatomes C5C6 or C6C7. After the diagnosis of compressive radiculopathy in all patients, they underwent surgical treatment and very soon developed very severe progression of muscle wasting which included muscles of limbs, trunk and bulbar innervated muscles with signs and symptoms of lower and up per motor neuron lesion. Five patients died from 12 to 15 months after surg ical treatment and two patients are still living. (C) 1998 Elsevier Science B.V. All rights reserved.