Fasciculations followed by dysphagia and neck weakness

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Alexkor

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Greetings from Finland and best possible day to you all,

A short summary of my spring and symptoms so far.

Background information:

30yo sporty male (pre-covid infection).
-Covid diagnosis end of March.
-After covid strong dizziness and fatigue. Diagnosed with long covid 10 weeks after initial sickness.
-Constant waves of sickness during spring/summer. Two dyspnea attacks during spring credited to long covid / anxiety attacks. Called the ambulance both times.
-Strong health anxiety during this period. Never had one before covid.
-Extensive search for alternative diagnoses, including bloodwork and MRI of head (beginning of June). No findings in these or clinical examination by neurologist.
-Was satisfied and prepared for the long haul / slow return to health from long covid.

THEN,
-Fasciculations started midway through June in stomach, within two week period spread everywhere, head to toe (first to left arm and bottom of both feet). Still ongoing.
-Generalized muscle pain in any used muscle, mostly bottom of both feet, almost burning-like. Also feelings of numbness, tickling and other strange sensations, especially in hands.
-Midway through July I started having problems with swallowing. First with liquids and rapid progression to solids (1 week). Swallowing symptoms were preluded by sinuitis for which I had antibiotics. Swallowing problems persist without significant progression as of now. Mainly on soft diet. Eating is a lot of work / fatiguing.
-Due to sudden dysphagia I went to endoscopy and was examined by ENT. No findings except minor inflammation of oesophagus in biopsy. Also ate medication for gerd 3 weeks without help.
-Sudden neck weakness developed on 10th of August that persists to this day (difficulty holding head up for extended periods, rest helps).
-Noticed minor problems with sphincter muscle.
-18th of August EMG of cheeck, tongue, sternocleidomastoideus, abdomen, axial muscles, right arm and both legs. Also clinical examination by neurologist. No findings.
-9th of September test (the fatigue test with electric shocks) for myasthenia gravis, preliminary result negative.

As of now I haven't had:
-Any noticiable problems with tongue, swallowing problems seem to concentrate to muscles in pharynx. No FEES or other swallowing studies done due to ENT saying these won't give additional information that would help me (?!).
-No problems with voice or talking other than perhaps a little easier fatigability of voice.
-No tongue fascultations.
-No weakness in other areas expect for bulbar. Neurologist didn't see any clinical weakness though.

I am considering on asking for transcranial magnetic stimulation (or MEP) test which is supposedly also sensitive for problems with upper motor neuron. For ease of mind / early diagnosis so medication might still be of use.

Any thoughts or advice?

Best regards and all answers are deeply appreciated,
-Aleksi

Ps. Latest neurologist thinks my symptoms are long covid related. The reason i feel uneasy is the major problem with swallowing/ rapid progression of new symptoms.

I will also be visiting the country's top long covid specialist next month.

Br. -Aleksi
 
Hello there-

Many people are reporting neurological and other symptoms after covid. Search any long covid support group on any social media platform and you will find hundreds of people reporting the exact same issues as you- many of whom developed them long after their acute covid infection. Pushing your doctors to provide tests they do not feel are warranted may not be as productive as joining a covid recovery support group and also working with your doctors to treat your symptoms with the understanding it is post viral. It sounds like you have good medical support if you will be seeing a covid specialist shortly.

Take care
 
I'm so glad to say that you don't present with anything like ALS. This has been confirmed by the neurological exam and EMG.
Your swallowing issues don't follow an ALS pattern at all either.

You do present with what we hear frequently reported with people suffering long covid.
I hope the upcoming appointment next month brings you to some solid help.
 
Thank you kindly for your replies, I will work with my doctors on long covid treatment.

Br. -Aleksi
 
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