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Dr. Rick, MD
Dr. Rick, MD, Board Certified MD
Category: Medical
Satisfied Customers: 8086
Experience:  20+ years as a doctor. Internal Medicine Internship in NYC
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Hi there. I hope you can help me. I have had strange very

Resolved Question:

Hi there. I hope you can help me. I have had strange very disruptive symptoms recently. My arms have been burning inside, numb/ tingly and weak feeling -they tire easily when lifting things for 6 weeks- especially started in my left arm. I also feel internal vibration and tremor with them. EMG was normal last week on upper extremities. Brain MRI normal. Neuro exam was normal. All autoimmune diseases and viruses have been ruled out. Sedimentation rate, ANA, RA normal. Regular blood work last month was normal. Cardio ECG was ok and ok chest x ray. I had twitches on my shoulders yesterday. I had a cold in Dec.

Since my last Neuro visit last week, I mentioned to the Rheumatoid md that they sent me to to rule out auto immune issues, that I have been noticing funny feeling/ weakeness in left leg for a week. But I can lift and push and move my leg just as much even though it 'feels' weak only inside. Left toe was numb for 2 nights when I woke up. Now my tongue is numb on the tip. I had been taking Antibiotics for an ear blister but iv been fine with no reaction for all 10 days of the atb. My Rheumatoid is not up on ALS. She does not think I have fybroymyalgia or Lupus or anything like this.

I asked a neuro on your site since much is already ruled out if this could this be ALS? Does ALS display like this? And so quickly in various locations ? Could it have been that it didn't show up on upper EMG as it wasn't ALS but it is in my leg now? Very worried about ALS.

The neuro on this website responded:"ALS will be very unlikely given that you are having sensory symptoms. ALS is a MOTOR neuron disease, meaning that it can produce symptoms that include muscle weakness, atrophy (decreased size of muscle), and muscle twitching, but it will NOT produce numbness, tingling, or burning sensations. Therefore, it becomes very unlikely that you are dealing with ALS or similar motor neuron disorders." KarayanMD

However,

I then asked this question back to the neuro on your site but I never got a response from your site: "Thanks for your helpful reply. However my leg though is feeling weak as i mentioned- for a week with no numbness. Could this be ALS? The numbness (sensory you mentioned which is not part of ALS) is only in the toe tip. I can still move my leg with the same strength though but it "feels weaker" than the other.

Do you think this could be ALS?
If not, what do you think could cause my toe and tongue numbness?
Also do you think this could all be signs of a tumor? Spinal or other?"

Thank you!

Optional Information:
Person's Gender: Female
Person's Age: 35

Already Tried:
Neuro, MRI, EMG on upper extremity, Cardio, Inf Disease MD, and Rheumatid MD.
Submitted: 2 years ago.
Category: Medical
Expert:  Camille-Mod replied 2 years ago.

Hi, I’m a moderator for this topic and I wonder whether you’re still waiting for an answer. If you are, please let me know and I will do my best to find an Expert to assist you right away. If not, feel free to let me know and I will cancel this question for you. Thank you!

Customer: replied 2 years ago.
Yes I am still waiting.
Expert:  Camille-Mod replied 2 years ago.

Thank you. Sometimes, finding the right Expert can take a little longer than expected and we thank you greatly for your understanding. We’ll be in touch again shortly:-)

Expert:  Camille-Mod replied 2 years ago.

Thank you for your patience, your business is very important to us, we are waiting on the Expert with the right expertise to come online. Feel free to let us know if you would like us to continue searching for an Expert or if you would like us to close your question. Thank you for your understanding!

Expert:  Dr. Rick, MD replied 2 years ago.
Hi. I have reviewed your posting and, while I must confess I am not a neurologist and don't profess to have any significant knowledge on treating ALS, I see that you have been waiting for quite some time for a response at this point. Might I suggest a course of action that may be helpful in your case?


It sounds like you have been receiving good care from very qualified physicians without any significant lasting improvement in your condition. At this point I think the best thing you can do would be to gather up copies of all your medical records and travel to a large University Teaching hospital. At an institution like that you could be evaluated and treated by a team of sub-specialists who are at the cutting edge of their respective fields. The best thing about these large teaching hospitals is that consultations are available with Professors and leaders in their field by just walking a few steps down the hall.

The Mayo Clinic in Rochester, Minnesota is an excellent example of just such a place as this. That being said there are many excellent teaching hospitals all across the country and I am sure that there is one near you.

If you could tell me what large city you live near and how far it would be possible for you to travel in seeking treatment I would be happy to give you some names. Of course, you could also ask friends and associated or check the internet yourself. Let me know what you would like to do.

Does this make sense to you?


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Let me know if there is anything else you would like to discuss pertaining to this issue.

If you would rather continue to wait for another Neurology opinion, please let me know and I will opt out so that another doc can address your concerns.

I wish you the best of luck and hope you feel better soon.

Dr. Rick, MD, Board Certified MD
Category: Medical
Satisfied Customers: 8086
Experience: 20+ years as a doctor. Internal Medicine Internship in NYC
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