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KarayanMD, Neurologist (MD)
Category: Neurology
Satisfied Customers: 830
Experience:  Board Certified Neurologist with Subspecialty in Clinical Neurophysiology. Private Practice.
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My arms have been numb and tingly, burny and weak feeling

Customer Question

My arms have been numb and tingly, burny 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. Brain MRI normal. Neuro exam was normal. All autoimmune diseases and viruses have been ruled out. Sedimentation rate, ANA, RA normal. I had twitches on my shoulders yesterday.
Since my last Neuro visit, I mentioned to my Rheumatoid md 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. Left toe was numb for 2 nights when I woke up. Now my tongue is numb on the tip. Rheumatoid is not up on ALS. She does not think it is fybroymyalgia or Lupus or anything like 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.
Submitted: 5 years ago.
Category: Neurology
Expert:  KarayanMD replied 5 years ago.

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.

Best wishes. Please let me know if there are more questions. If this has been helpful, please click on ACCEPT so I can be reimbursed for the time taken to answer your question. BONUSES and positive feedback appreciated.

KarayanMD and other Neurology Specialists are ready to help you
Customer: replied 5 years ago.
Thanks for your helpful reply. My leg though is feeling weak as i mentioned for a week with no numbness. I can still move it but it feels weaker than the other. Do you think this could be ALS? What do you think the toe and tongue numbness could be then?
Customer: replied 5 years ago.

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.


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

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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.

Expert:  KarayanMD replied 5 years ago.

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.

Customer: replied 5 years ago.
My toe is not numb anymore. Now my left leg muscle is perceived as weak in my leg. But I can move it. Can ALS start with perceived weakness vs actual weakness? Is it possible that my left arm and now left leg were perceived as weak and my nerves and anxiety created the burning, tingling and numbness masking the true problem which is only perceived muscle weakness? Could this be ALS? Sorry, still worried. In fact I got a massage today and I do everything with my right hand and arm. The massage lady said I am much tighter in my arms and legs on my left. This is where I feel weak.
Expert:  KarayanMD replied 5 years ago.
The odds that you have ALS are very low. I advise you to see your neurologist as I do not feel further written conversation will be of much help without an examination. Best of luck. You may consider asking another expert on Just Answer if you would like a 2nd opinion.