[39M] With leg weakness and muscle twitching
Patient Description
A 39-year-old male reports experiencing sudden onset leg weakness since early October, following a period of high physical activity. The weakness is primarily in the calves and glutes, with associated muscle twitching beginning shortly after. The patient notes a slight decrease in muscle size, likely due to reduced physical activity, and finds it harder to walk downhill. There is no difficulty with balance, speech, or swallowing. The patient had COVID-19 in July, with a lingering cough for a month post-recovery. A full neurological workup, including an MRI and spinal tap, revealed high protein levels in the cerebrospinal fluid but no other abnormalities. The patient has a history of hypertensive disorder and no known allergies. No new medications or supplements have been started recently, and there is no family history of neurological disorders or autoimmune diseases.
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Arora's Assessment
What might be happening
Based on your symptoms of leg weakness and muscle twitching, here are some possibilities:
- Benign Fasciculation Syndrome (BFS): This condition involves muscle twitching and can occur without serious underlying issues. It's often not accompanied by significant weakness.
- Post-Viral Syndrome: After infections like COVID-19, some people experience lingering symptoms, including muscle weakness and twitching.
- Peripheral Neuropathy: This involves nerve damage that can cause weakness and twitching, but it usually comes with other symptoms like numbness or tingling.
Your recent tests, including an MRI and neurological workup, were normal except for high protein in your spinal tap. This can sometimes indicate inflammation or other non-specific changes.
What you can do
- Monitor Symptoms: Keep track of any changes or new symptoms. Using MDandMe to journal your symptoms can help you notice patterns and share detailed information with your healthcare provider.
- Stay Active: Continue with gentle exercises that you can tolerate, as staying active can help maintain muscle strength.
- Manage Stress: Stress can sometimes exacerbate twitching, so consider relaxation techniques like deep breathing or meditation.
What you should look out for
- Seek Medical Attention If:
- You notice significant worsening of weakness or new symptoms like numbness or difficulty with coordination.
- You experience any changes in speech, swallowing, or breathing.
Remember, it's important to follow up with your healthcare provider if you have concerns or if your symptoms change.
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2 mo ago