Can a local neurologist diagnose, or would I need a specialist?

[piggy]

I've been having body wide twitching, stiff fingers, right arm that feels sore and tired all the time and my right knee pops SO MUCH(I've read that it can be due to weak muscles) and now my leg feels weak and knee has been buckling a few times a day. Now, I feel like it feels harder to chew and swallow, and when I took a small pill I felt like it scratched my throat. My jaw is also always sore.

I'm also getting post nasal drip and constant sore throat and my family is just saying it's due to me crying every hour about this. This all happened within a month. I went to a neurologist and had a EMG on my arm and fingers which only showed carpal tunnel. However, my leg/knee didn't start to buckle and feel weak until a few days after.

My questions are, is a local neurologist able to diagnose or should I go to a specialist to be sure? Also, can symptoms in an arm, leg, fingers, and bulbar symptoms all occur within a month?

I'm 27, for context

 

[lgelb]

The short answer is yes, the local neuro is fine for ruling out ALS, and no, the progression that you describe doesn't sound like ALS at all.

Do you sleep, work, or lounge on your R side? It sounds like it may be overloaded somehow. If you are crying a lot, that sounds like it could affect your sleep and vice versa, which can worsen everything you described, including your awareness of minor things. A sore jaw could mean you are clenching your teeth in sleep, which can be improved with a bite guard that you can get from your dentist.

I would expect the neuro or your PCP to refer you for testing or specialty care to rule out a treatable cause for the popping knee, so if you don't have clear direction on that, I would circle back to one or both. Also, treating the carpal tunnel early or not overdoing repetitive motions that cause it can pay dividends later in life.

 

[piggy]

Thank you for your reply! I do sleep on my right side, and I've been waiting tables for the past 8 years so I carry heavy trays all day, but thats all. I'm desperately trying to find answers because I can't find anything else that would cause my quad to feel weak and make my knee buckle and pop as well as my right arm to be fatigued and sore all the time.. those are my most concerning symptoms to me, on top of twitching.

 

[lgelb]

I understand, but you just wrote about two things that could affect your R side. I would also ask about a PT evaluation, which your PCP can order, with support from maybe some imaging to rule out other things and an exam that suggests clinical weakness of the joint (NOT the same as ALS).