Suspecting that you have amyotrophic lateral sclerosis (ALS)?
I started experiencing weakness in my hands and feet in December 2017, and it has progressively worsened.
I feel that my limbs are becoming less agile, and I have also developed muscle twitching, numbness, and soreness.
Recently, my tongue has started to feel a bit numb as well.
I have been seeking medical attention since last year and have undergone nerve conduction studies and EEGs, which did not reveal any abnormalities.
In early December of this year, I had an electromyography (EMG) test that also showed no irregularities.
I would like to ask: if these tests have not found any issues, should I not worry about being diagnosed with amyotrophic lateral sclerosis (ALS)? My doctor told me that I do not need to return for follow-up, but my condition has not improved.
Are there other potential causes that could lead to similar symptoms? This situation has been very distressing for me and has even made me feel depressed...
I hope you can help me and provide some direction.
Thank you!
Tammy, 20~29 year old female. Ask Date: 2018/12/26
Dr. Lai Xiangrong reply Rare Disease
Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig's disease, is characterized by significant muscle weakness and/or atrophy.
Other prominent symptoms include difficulty swallowing, cramps, or muscle stiffness.
Muscle weakness may affect the limbs and/or result in slurred speech and nasal voice.
Sensory nerves and the autonomic nervous system are generally unaffected, so there will be no numbness, distinguishing it from your symptoms, and you need not worry about having ALS.
If you are truly concerned, you may consult a specialist in neuromuscular disorders within the field of neurology.
Reply Date: 2018/12/26
More Info
Understanding Amyotrophic Lateral Sclerosis (ALS) and the persistence of symptoms despite normal test results can be a complex and distressing experience. Your symptoms of progressive weakness in the limbs, muscle twitching, numbness, and tingling sensations, particularly in the tongue, are concerning and understandably troubling. However, the fact that you have undergone several diagnostic tests, including nerve conduction studies, EEGs, and electromyography (EMG), which have returned normal results, is a significant factor to consider.
Firstly, it's important to note that ALS, also known as Lou Gehrig's disease, is a progressive neurodegenerative disorder that affects motor neurons in the brain and spinal cord. The diagnosis of ALS typically involves a combination of clinical evaluation and specific tests to rule out other conditions. The absence of abnormalities in your EMG and other tests suggests that the likelihood of ALS is low, as these tests are designed to detect the kind of nerve and muscle dysfunction associated with the disease.
However, the persistence of your symptoms raises valid concerns. There are several potential explanations for your condition that may not be related to ALS. For instance, conditions such as peripheral neuropathy, multiple sclerosis, or even anxiety and stress-related disorders can present with similar symptoms. Peripheral neuropathy, for example, can cause weakness, numbness, and tingling due to nerve damage, which can arise from various causes, including diabetes, vitamin deficiencies, or autoimmune diseases.
Another possibility is that your symptoms could be related to a functional neurological disorder (FND), where neurological symptoms occur without a clear structural or biochemical cause. This can often lead to significant distress and can mimic the symptoms of more serious neurological conditions.
Given that your symptoms have not improved and are causing you distress, it would be prudent to seek further evaluation. While your doctor may have suggested that you do not need to return for follow-up, it is essential to advocate for your health. Consider seeking a second opinion from a neurologist who specializes in neuromuscular disorders or functional neurological disorders. They may offer additional insights or recommend further testing that could help clarify your diagnosis.
In the meantime, addressing your mental health is crucial. The anxiety and depression stemming from your health concerns can exacerbate physical symptoms. Engaging in supportive therapies, such as counseling or cognitive behavioral therapy, can be beneficial. Additionally, practices such as mindfulness, meditation, and gentle physical activity may help alleviate some of the stress and improve your overall well-being.
In summary, while the normal results of your tests are reassuring in terms of ruling out ALS, the persistence of your symptoms warrants further investigation. It is essential to remain proactive about your health and seek additional opinions or evaluations if necessary. Remember, you are not alone in this journey, and there are resources and support available to help you navigate your concerns.
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