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Hi. Thanks for your question.
I am a board certified neurologist in the U.S.
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.
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This is a follow up to my last question. Hopefully you can read the last question as well?Thanks for your helpful reply. However my leg though is feeling weak as i mentioned though, for a week with no numbness. The numbness (sensory you mentioned) 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 noy, what do you think the my toe and tongue numbness could be then? They don't know why my arms feel weak and burny with internal vibration with normal arm EMG.Holly
Optional Information: Person's Gender: Female Person's Age: 35 Already Tried: This is a continuation to the last question. MRI normal, EMG normal, Autoimmune Disease already ruled out by Rheumatoid and all Viruses ruled out by infect disease MD. No inflammation identified. Until toe and tongue numbness, last neuro exam last week was normal even though had and arm burns and tingles and gets tired holding things and lifting. Neuro though fybroymyalgia. Rheumatoid said it is not that.
Hi Holly, Sorry for the delay.
It will be very difficult to determine what is causing your various symptoms, but I would definitely consider having blood testing with thyroid testing and B12 and folic acid levels if these haven't been checked. It seems you have had a pretty thorough workup so far, without any clear answers. Spine MRI could be considered also if not already done to rule out problems with your spinal cord or the nerve roots in the low back, which could cause weakness and numbness symptoms in your foot or leg. Again, I think the odds of ALS are very small because of the numbness you are experiencing which would not be seen with ALS.
I would have you talk with your neurologist again about your concerns, and to see what the next step in workup is.
Best of luck. Dr. Karayan.