[59M] Experiencing sudden and intermittent paralysis with weakness in arms and legs

Question

Is this sounding like ALS?

Patient Description

A 59-year-old male reports experiencing sudden and intermittent weakness in both arms and legs, leading to daily falls and an inability to move limbs. This condition has persisted for months, with the patient rating the severity of weakness as 9 out of 10. The weakness affects both arms and legs simultaneously and comes and goes. Despite these challenges, the patient does not experience difficulty breathing, changes in speech, numbness, tingling, severe headaches, or changes in vision. Additionally, the patient feels fatigued and has difficulty walking. There is no recent history of injuries, accidents, or any known triggers that could explain the onset of these symptoms. The patient has a medical history of celiac disease and dysautonomia, diagnosed 20 years ago, and is currently taking daily Vitamin B12 and NaCl supplements. There are no known allergies to medications, and no use of recreational drugs, alcohol, or tobacco products. The patient has not been exposed to any other supplements or medications that could contribute to the symptoms.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are some possible causes for your symptoms:

  • Neurological conditions: Your symptoms of intermittent weakness in your arms and legs, leading to falls, could be due to a neurological condition. This could include conditions like Multiple Sclerosis, Myasthenia Gravis, or a form of peripheral neuropathy. These conditions can cause muscle weakness and difficulty walking.

    • Testing for these conditions often involves neurological exams, blood tests, and sometimes imaging or other specialized tests. Treatment varies depending on the specific condition and could involve medication, physical therapy, or other interventions.

  • Dysautonomia: This is a condition that affects the autonomic nervous system, which controls functions like heart rate, blood pressure, and muscle function. It can cause a variety of symptoms, including weakness and fatigue.

    • Treatment often involves managing symptoms and can include medications, lifestyle changes, and sometimes interventions like physical therapy.

  • Celiac disease: While celiac disease primarily affects the digestive system, it can also cause a range of other symptoms, including fatigue and weakness. This is usually due to malabsorption of nutrients.

    • Treatment involves a strict gluten-free diet to manage symptoms and prevent damage to the intestines.

What you can do

  1. Seek immediate medical attention: Given the severity and duration of your symptoms, it's important to seek medical attention as soon as possible. A healthcare provider can conduct a thorough evaluation and order appropriate tests to determine the cause of your symptoms.

  2. Keep a symptom diary: Note down when your symptoms occur, their severity, and any potential triggers. This can help your healthcare provider in diagnosing your condition.

  3. Stay safe: Given your frequent falls, consider making modifications to your home to prevent injuries. This could include removing tripping hazards, installing handrails, and using assistive devices.

What you should look out for

  • Worsening symptoms: If your weakness or falls become more frequent or severe, seek medical attention immediately.
  • New symptoms: If you develop new symptoms such as difficulty speaking, swallowing, or breathing, or changes in your vision or mental status, seek immediate medical attention.
  • Injury from falls: If you injure yourself during a fall, seek medical attention.

Remember, while I strive to provide accurate and helpful information, I'm not a doctor. It's important to consult with a healthcare provider for a formal diagnosis and treatment.

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8 mo ago

People Also Ask

What are some common neurological conditions that can cause sudden weakness in the arms and legs?

Common neurological conditions that can cause sudden weakness in the arms and legs include Multiple Sclerosis, Myasthenia Gravis, and peripheral neuropathy. These conditions can disrupt nerve signals to the muscles, leading to weakness and difficulty in movement.

How does dysautonomia affect muscle function and what are its common symptoms?

Dysautonomia affects the autonomic nervous system, which controls involuntary functions like heart rate and blood pressure. It can lead to symptoms such as muscle weakness, fatigue, dizziness, and fainting due to improper regulation of these functions.

Can celiac disease cause symptoms beyond digestive issues, such as muscle weakness?

Yes, celiac disease can cause symptoms beyond digestive issues, including muscle weakness and fatigue. This is often due to malabsorption of essential nutrients, which can affect overall muscle and nerve function.

What steps can be taken to prevent falls at home for someone experiencing muscle weakness?

To prevent falls at home, consider removing tripping hazards, installing handrails in key areas, using non-slip mats, ensuring good lighting, and possibly using assistive devices like canes or walkers to improve stability.

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2 Comments

Leo#3962

8 mo ago

This fortunately does not sound like ALS, although you should definitely try to get in to see a neurologist asap given your falls and mobility issues. Here is why:

ALS is a progressive disease beginning with asymmetric limb weakness, speech difficulties, and sometimes cramping. It does not typically "come and go".

So what comes and goes? Myasthenia and lambert-eaton syndrome are two problems that affect the junction between muscles and nerves. They can cause weakness that either worsens as the day go on (myasthenia) improves as the day goes on (lambert-eaton). There are probably additional explanations too

It is important to see a doctor for these conditions because they can sometimes be associated with additional underlying problems that are best treated early

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Janice#4034

8 mo ago

ALS tends to be more slowly progressive rather than fluctuating as you are describing

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