MND/ALS or Something else. Sign of mnd?

Opinion: Based on the symptoms you've described - a dent/atrophy in one leg near the ankle, slight speech issues, hyperreflexia (brisk reflexes) on the same side, nail pitting, and perceived memory problems, it's understandable to be anxious about the possibility of motor neuron disease (MND) like ALS. However, these symptoms alone are not necessarily diagnostic of MND. The normal MRI findings are reassuring as MND often shows specific changes like hyperintensities in the brain and spinal cord on MRI. Additionally, MND typically presents with progressive and widespread muscle wasting, weakness and fasciculations rather than localized findings. That said, the constellation of symptoms you describe could potentially be due to a number of other neurological or systemic conditions. A thorough clinical examination and investigation is required before arriving at any conclusion. Next Steps: 1. I would recommend scheduling an appointment with a neurologist, preferably at a university or MND clinic, for a comprehensive evaluation. They have the expertise to properly assess your symptoms. 2. Be prepared to undergo a battery of tests - detailed neurological examination, nerve conduction studies, EMG, blood tests etc. to investigate the underlying cause. 3. Bring all your previous medical records, MRI scans etc. for the neurologist's review. 4. Until a definitive diagnosis is made, try not to catastrophize. Many of these symptoms can have benign or treatable causes unrelated to MND. 5. If needed, I can refer you to a speech therapist and physiotherapist to help manage your speech and limb symptoms in the interim. While I understand your anxiety, providing a diagnosis based only on your reported symptoms would be premature. A methodical workup by a neurologist is crucial to pinpoint the cause and initiate appropriate management. My role is to coordinate your care and ensure you receive the best possible treatment once the diagnosis is established. Please feel free to reach out to me if you have any other concerns. Taking this step-by-step and trying to remain positive during this process is important.