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Diagnosed With POTS. MRI Brain And Chest X-ray Done. Having Weakness In Arm. Worrisome

Posted on Wed, 13 Mar 2013

Question: Hi my name is XXXXXXX im 26 year old female diagnosed with POTS. symptoms are fatigue , inappropriate tachycardia , very weak , and more weak in the arms than anything. I have had a negetive MRI brain, positive tilt table test, abnormal Sqart test, normal Echo stress test. Normal chest xray. CBC BMP normal. normal thyroid function tests. normal adrenal tests, thyroid nodule with biopsy normal. Recently I have ahd weakeness in my left arm with tremors up in my shoulder and bicep area, and its constantly achy i am very worried about ALS. i can still lift weights I can still do fine motor control but the tremors and weakness (moreso its fatigue feeling) is there- im very worried and an anxious person by heart.

Answered by Dr. Gopal Krishna Dash (18 minutes later)

Hello,

Thanks for posting this query in XXXXXXX

Weakness and tremor of one side is most likely a neurological problem and it can be due to a group of nerve problem (called as brachial plexopathy), nerve root compression or nerve problem.

Generally a detailed clinical neurological examination can localize the site of lesion in nervous system. The presence of pain, ache etc is a strong point against ALS- amyotrophic lateral sclerosis.

The most classical symptoms of ALS are weakness, wasting of muscles, twitching of muscles (isolated twitching without wasting is not a feature of ALS), difficultly in speaking, drinking water etc.

You need neurological evaluation, nerve conduction test and MRI of the cervical spine to clinch the diagnosis.

Please don’t worry, as you don’t have ALS

I hope that I have answered your query

In case you have further query, please get back to me

Best wishes

Dr Gopal K Dash
Neurologist XXXXXXX Hrudayalaya Hospital, Bangalore
email: YYYY@YYYY

Above answer was peer-reviewed by : Dr. Mohammed Kappan

Follow up: Dr. Gopal Krishna Dash (28 minutes later)

I was seen by a chiropracter not long after my diagnosis, and he said due to pregnancy my lumbar area ( I dont remember exactly which part of it ) was 10 degrees off and part of my thorasic was just a bit off too) . . . . I dont understand the difference between weakness and fatigue? so this drops down to things like MS... right ? I see a neuromuscular doctor at the cleveland clinic tomorrow. im just trying to ease my fear of ALS . . .

Answered by Dr. Gopal Krishna Dash (26 minutes later)

Hello,

Thanks for the feed back,

Your symptoms are neither suggestive of MS nor ALS. I have alo mentioned the neurological possibilities based upon the data provided. Weakness is an objective thing that we measure strength in the muscle by a formal neuro exam. Fatigue is the feeling tired.

Symptoms MS are weakness of both the legs, numbess of face, imbalance, visual complaints and so on. Further you dont XXXXXXX the required clinical criteria for the diagnosis of MS.

Please relax as you donot have either ALS or MS

The neurologist will help you

I hope that I have answered your query

In case you have any further queries, please get back to me

Best wishes

Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Aparna Kohli