I have weakness in right leg with tingling and numbness in limbs. Could this be MS or ALS?

Hello,

Welcome to icliniq.com.

I would like to know some details about your symptoms. As you mentioned that after your infection before few months, neuropathy came into play, I would like to know the details of neuropathy and its symptoms since that time.

What symptoms had you developed at that time after infection? Do you have tingling or weakness or impairment of sensation of touch over leg/arm?

Or do you experience something else? Did you undergo nerve conduction study at that time? If yes, please send the NCV test reports and graphs. What kind of neuropathy was diagnosed at that time? And what treatment was planned? Are you still taking medications for that? Please send the prescriptions, discharge summary, MRI reports, and lab test reports, as you mentioned.

Since when feeling of buckling of the right leg while walking and not feeling scratching of calves started? Is it since the beginning of neuropathy symptoms, or it appeared lately? Do neuropathy symptoms showed some improvement, or is it static or progressing? Do you have any difficulty in controlling urine (at times of having a desire to pass urine)? Do you have any paresthesia (tingling sensation or burning sensations) at legs/arms? Do you have any difficulty in having a grip over footwear while walking?

Hello,

Welcome back to icliniq.com.

I seen your reports (attachment removed to protect patient identity).

As you mentioned that weakness in right leg and tingling sensations over legs, arms, shoulder, tongue started only this week and you mentioned it as neuropathy. I am little confused that you labelled it neuropathy by yourself or it has been diagnosed as neuropathy by a doctor?

Also, please mention that in which which part of leg, arm, you feeling tingling sensations? (e.g. shoulder region, arm, elbow, forearm, palm, fingers, hip region, buttocks, back of thigh, front of thigh, calf region, feet, etc.). Do you have any difficulty in negotiating your right foot into footwear? Do you have any difficulty in getting up from squatting position or any lower back pain?

How is your mood in the last week happy, worried or anxious, sad, irritable, or something else? How is your common mood in daily activities? How is been your sleep in the last week? Is it good sleep or did you find difficulty in getting sleep after lying in the bed? Do you have frequent awakening, early morning awakenings, or something else? Did any of your friend or family member pointed out that your walking style (gait) got changed in this week?

Regarding headaches/ migraine., since how many years, you have migraine issues? since when you are on Emgality? Had you been tried on oral prophylactic medications before? If yes, which which medications you tired before? Did they not worked? How is your migraine frequency on oral medications? Do you have any symptoms of redness, burning of face and skin while going in the sunlight (photosensitivity), joint pains or swelling?Do you get frequent mouth ulcers?

Hello,

Welcome back to icliniq.com.

As per your description, you need to do a clinical examination to check the power of different muscles of your leg, DTR (deep tendon reflexes), plantor response along with gait examination. For that you should consult a neurologist physically.

And with the history of multiple trigger points for pain, anxious mood, pressure on head, and sleep onset and maintenance difficulty there may be possibility of associated anxiety disorder, or fibromyalgia with/without mild depression.

I also recommend you to meet a psychologist/ psychiatrist for psychological analysis and you may require psychotherapy medications. But before labelling these symptoms as on-organic, few things must be ruled out. For that, I also recommend to undergo some investigations.

Hello,

Welcome back to icliniq.com.

By your clinical history and description, ALS or MS does not come as a priority differential in my mind. Still, investigations are required to rule out organicity of your symptoms.