How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask Dr. Arun Phophalia Your Own Question

Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 29566
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
Type Your Health Question Here...
Dr. Arun Phophalia is online now
A new question is answered every 9 seconds

About a month ago I had an episode at work that appeared as

Resolved Question:

About a month ago I had an episode at work that appeared as a small TIA. It started when I couldn't get my mouse on my computer to move correctly. After a few seconds I realized it wasnt my mouse but rather my right hand. Then I realized my right hand had gone numb. Several seconds later full feeling came back however my face felt odd. By the time I got over to someone my right side of my face under paralysis and my speech was slurred. again this only lasted a couple seconds. The whole episode was over in about five minutes followed my a slight headache and soreness on the right side of my face. I was realsed from the hospital told that it was anxiety/migraine. After the fact for weeks my right. Eye would twitch as well as my upper lip from time to time and i would have a slight pulling in my neck from time to time.Since then my legs have also been odd. The right one use to fall asleep very easily and as of the past month started to twitch a little under my knee...sometimes my left as well. It took me two months to get rid of the pain in my face as I was told by several doctors that I did or didn't have a sinus infection... after I woke up one morning with my face swollen on the right side near the maxillary sinus they labelled it a sinus infection. The antibotics seemed to have worked however im now wworried about my legs and worried what triggered the episode at work. At times I also have a pressure feeling in my arms like something is pushing against them.... that doesn't last long. I had a MRI. And CT and all came back clear. I have no problem believing this is anxiety but I just was to make sure it's nothing more serious like ALS. Thank you so much for your time.
Submitted: 10 months ago.
Category: Health
Expert:  Dr. Arun Phophalia replied 10 months ago.

Hello Valerie ,
I am Dr. Arun and will be helping you today.


ALS typically progresses within the area first affected and then to adjacent, contiguous regions. The symptoms do not regress or resolve usually. The diagnoses of ALS requires the following criteria;


1) Signs of lower motor neuron (LMN) degeneration by clinical (physical exam), electrophysiological (EMG and NCV) or neuropathologic examination,

2) Signs of upper motor neuron (UMN) degeneration by clinical examination, and


3) Progressive spread of signs within a region or to other regions, together with the absence of:
a) absence of other neurological diseases by the electrophysiological studies.
b) Neuroimaging (CT scan or MRI) evidence of other disease.

Thus your symptoms are unlikely to be ALS. Your symptoms are best explained by the migraine variants (atypical migraine), which have various neurological symptoms. Please read about the various wide presentation of the migraine variants in this authentic resource;

http://emedicine.medscape.com/article/1142731-overview


The other possibilities to consider for your symptoms would be:

1) Electrolyte derangement; unusual activity or unaccustomed activity 3-4 days ago before the episode may be responsible for it.

2) Increased caffeine or alcohol (if you do)

3) Medications or herbs (if you were on any).

4) Deficiency of vitamins.

You may consider following investigations (if not done earlier) just for the precautions;

1) electromyography (EMG)

2) nerve conduction velocity (NCV)

3) blood electrolytes like calcium, magnesium, potassium, sodium, etc

4) thyroid and parathyroid function tests

5) blood chemistry and complete metabolic profile.



Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

Thanks for using Just Answer.

 

I hope that this information is helpful. If you need further information, please just send me a reply asking for clarification. Once you are satisfied, I hope you will enter a positive rating so that I will be credited for assisting you. Thanks again for using this service. Your business is appreciated.

Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 29566
Experience: MBBS, MS (General Surgery), Fellowship in Sports Medicine
Dr. Arun Phophalia and 4 other Health Specialists are ready to help you
Customer: replied 10 months ago.

thank you for your answer.I am happy to know that it doesn't sound like ALS. I had blood work done about a month ago. thyroid was normal. potassium and b12 was low and now taking supplements. the twitches and and leg issues subside when I walk...i also have shin splits like pain but i believe that would be due to the vitamin def. would that explain things?

Expert:  Dr. Arun Phophalia replied 10 months ago.
You are very welcome, Valerie.

Deficiency of vitamin B 12 and potassium explain all the symptoms. Twitching is caused by minor muscle contractions in one particular area, or the persistent and uncontrolled twitching of a muscle group in a distribution of a single nerve fiber or filament. Usually they are benign and resolve on their own. B 12 deficiency is one of the common cause of persistent twitching. This is unlikely to be neurological in origin.

It is privilege assisting you.
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 29566
Experience: MBBS, MS (General Surgery), Fellowship in Sports Medicine
Dr. Arun Phophalia and 4 other Health Specialists are ready to help you

JustAnswer in the News:

 
 
 
Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.
 
 
 

What Customers are Saying:

 
 
 
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
< Last | Next >
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
  • I thank-you so much! It really helped to have this information and confirmation. We will watch her carefully and get her in for the examination and US right away if things do not improve. God bless you as well! Claudia Albuquerque, NM
  • Outstanding response time less than 6 minutes. Answered the question professionally and with a great deal of compassion. Kevin Beaverton, OR
  • Suggested diagnosis was what I hoped and will take this info to my doctor's appointment next week.
    I feel better already! Thank you.
    Elanor Tracy, CA
  • Thank you to the Physician who answered my question today. The answer was far more informative than what I got from the Physicians I saw in person for my problem. Julie Lockesburg, AR
  • You have been more help than you know. I seriously don't know what my sisters situation would be today if you had not gone above and beyond just answering my questions. John and Stefanie Tucson, AZ
  • I have been dealing with an extremely serious health crisis for over three years, and one your physicians asked me more questions, gave me more answers and encouragement than a dozen different doctors who have been treating me!! Janet V Phoenix, AZ
 
 
 

Meet The Experts:

 
 
 
  • Nurse Milli, RN

    Nurse (RN)

    Satisfied Customers:

    4043
    20 years experience in many areas of Nursing. Both Hospital and Private Practice experience.
< Last | Next >
  • http://ww2.justanswer.com/uploads/NU/nursescare4u/2013-3-31_03429_JApic.64x64.jpg Nurse Milli, RN's Avatar

    Nurse Milli, RN

    Nurse (RN)

    Satisfied Customers:

    4043
    20 years experience in many areas of Nursing. Both Hospital and Private Practice experience.
  • http://ww2.justanswer.com/uploads/agketch/2008-7-14_184046_drketchresized.jpg Dr. Ketch's Avatar

    Dr. Ketch

    Doctor

    Satisfied Customers:

    102
    Medical Degree, Former Assistant Professor at School of Medicine at Yale University
  • http://ww2.justanswer.com/uploads/FA/FamilyPhysician/2013-8-31_191624_JA550x500Photo.64x64.jpg Family Physician's Avatar

    Family Physician

    Doctor (MD)

    Satisfied Customers:

    5622
    Emergency Medicine and Family Practice for over 26 years
  • http://ww2.justanswer.com/uploads/drphophalia/2007-08-23_095626_dr._arun_phophalia.jpg Dr. Arun Phophalia's Avatar

    Dr. Arun Phophalia

    Doctor (MD)

    Satisfied Customers:

    17025
    MBBS, MS (General Surgery), Fellowship in Sports Medicine
  • http://ww2.justanswer.com/uploads/VA/VANP/2012-6-6_235535_Skye2.64x64.jpg A. Schuyler, NP's Avatar

    A. Schuyler, NP

    Nurse Practitioner

    Satisfied Customers:

    12170
    Board Certified NP, MS, RN. Private practice & hospitalist
  • http://ww2.justanswer.com/uploads/TA/tazechip/2012-6-7_135230_drpic.64x64.png Dr. Chip's Avatar

    Dr. Chip

    Doctor (MD)

    Satisfied Customers:

    10029
    Over 20 yrs of Family Practice
  • http://ww2.justanswer.com/uploads/neurosurg/2009-10-06_120923_profile.jpg Dr. Mark's Avatar

    Dr. Mark

    Doctor (MD)

    Satisfied Customers:

    6234
    U.S. Physician/Surgeon in Neurosurgery