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Hi, I Am A 23 Year Old Otherwise Healthy Female
Question: Hi, I am a 23 year old otherwise healthy female who for lack of a better term has been through hell this past month. Constant numbness/tingling of lower extremities, intense muscle twitches and fasciculations that drive me absolutely nuts. They say I have hyperreflexes but they are symmetrical so it's apparently ok. I have had MRI of brain, cervical, and thoracic spine, nerve conduction studies, lumbar puncture to check for everything under the sun, and an EMG of my lower extremeties. I have a really bad tremor in my left hand that they don't seem to worry about either. They don't really have an answer except that I had COVID July 19 w/ pneumonia and maybe my body is responding weird neurologically, but I am not convinced. I am absolutely terrified of ALS. Is it possible to have a normal EMG and have ALS? was my EMG possibly done too early?
Brief Answer:
Unlikely to be ALS.
Detailed Answer:
Thank you for posting your query.
I am Dr Sudhir Kumar, Neurologist, and I would try my best to help you.
I have noted your clinical details. The chance of you having ALS is unlikely. In ALS, patients have pure motor symptoms- weakness and wasting (thinning) of muscles. Sensory symptoms (such as numbness and tingling) do not occur in ALS. Secondly, EMG can not be normal in ALS.
Your symptoms are most likely related to COVID-19 infection. COVID infection is known to affect muscles and peripheral nerves. I have noted that nerve conduction studies are normal, however, it can be normal in about 20-25% of cases.
There is no need to worry, as most patients improve over time. Recovery may take 3 months.
Treatment is mainly symptomatic (such as pregabalin for tingling).
I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.
Wishing you good health,
Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX XXXXXXX
Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar
My BLOG: http://bestneurodoctor.blogspot.in
Unlikely to be ALS.
Detailed Answer:
Thank you for posting your query.
I am Dr Sudhir Kumar, Neurologist, and I would try my best to help you.
I have noted your clinical details. The chance of you having ALS is unlikely. In ALS, patients have pure motor symptoms- weakness and wasting (thinning) of muscles. Sensory symptoms (such as numbness and tingling) do not occur in ALS. Secondly, EMG can not be normal in ALS.
Your symptoms are most likely related to COVID-19 infection. COVID infection is known to affect muscles and peripheral nerves. I have noted that nerve conduction studies are normal, however, it can be normal in about 20-25% of cases.
There is no need to worry, as most patients improve over time. Recovery may take 3 months.
Treatment is mainly symptomatic (such as pregabalin for tingling).
I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.
Wishing you good health,
Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX XXXXXXX
Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar
My BLOG: http://bestneurodoctor.blogspot.in
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
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