Possible ALS

[Marskaya]

Hi!
I’ve had on and off shortness of breath after second COVID for 3 month. Also weird sensation of pressure, tightness in base of my neck behind my collarbone, usually in a morning. Had Botox and fillers done in April and after suffering terrible symptoms: generalized muscle weakness (especially hips and shoulders), shaking hands, internal body vibrations. It’s been 6 month already and I’m declining. Had clear EMG aim June. Now have extreme thirst/dry mouth. Developed twitches in my right triceps a week ago. Recent blood work shows low CO2 and elevated Anion gap. Neurologist tested for MG (negative) he suspects. Clear MRI so no MS. He suspects ALS but choosing a “wait and see” approach.
I’m very scared of ALS.
Will EMG show abnormality if it’s a torso onset of ALS ? Could EMG be done too early? Does ALS usually starts in one side? Mine is both side weakness , mostly shoulders and hips/core muscles.

 

[lgelb]

Yes/unlikely if there are functional deficits/yes. So the chances are excellent that you do not have ALS, especially since about one out of ten Covid cases results in some kind of ongoing disability, that can last months to years. Botox can have its own side effects.

In New York, there should be several post-Covid clinics you could contact, though they stay busy so there may be a wait. A standard physical medicine/rehabilitation practice may also be helpful to help sort out treatable symptoms.

 

[Marskaya]

Thank you for your reply! Do you know by any chance how to rule out respiratory/torso onset ALS? My symptoms are mostly in my torso (breathing difficulties, pressure behind my collarbone, widespread twitches and generalized weakness) they only did EMG on my right leg and hand. So they also do EMG son chest/torso?

 

[Nikki J]

Respiratory als would show in pulmonary function tests. There are many other causes for abnormal pfts but unless there are specific abnormalities they would rule out respiratory als. Respiratory al is rare and when it happens mostly in elderly men