Patient: SO i was in Pakistan from september till december and a week before coming back i started to get burning sensation in my feet, which than turned into cold/chills and tingling feeling. I got back on december 13th and was fine but about a week ago i started having more symptomssame burning/chills and tingling in feetpain in my leg and sometimes both legs, around joints and calf but sometimes in thighs tooI had pain in arms and tingling feeling in my hands,My hands were also shakingI had pain and stiffness in my shouldersI had stiffness in my face, sometimes on the face, other times around mouth and neck and even foreheadSometimes i feel a numbness/tingling on my lipThan some of these things went away and now i have the following:I have weakness in my legs, especially the joints and i sometimes feel painmy feet are tingling/numbmy neck feels stiffmy face and lips feel stiff and lips are feel numbHere is my medical History:I was diagnosed with type 2 diabetes in July(but i could have had it much longer, i drank a lot of sodas and ate chips and cookies,candies for past 10 years. I don’t remember drinking a lot of water).I did a A1C and it was 6.4 in augustI did one few days ago it was 6.2I really took care of myself after i was told about my diabetes but than when i went back to pakistan i wasn’t really that careful. I got married so you know how its hard to be careful around food when its your weddingWhen i started having these issues about a week ago i checked my Sugar fasting and it came back 141I ate and took 500MG of metformin and 4 hours later checked again it was 188next day fasting 137 than after eating 4 hours later 173But now its under control again. I asked a doctor and he did the physical and said i don’t have ALS or ParkinsMY thyroid came back lowVitamin D was 11.3(normal range being between 30-80)I had high white blood cellsmy sugar was 146(but i had just ate)VItamin B was normal but i read i should have been fasting 6-8 hours before doing the testSince these are ALS forums i was wondering if some or any of these symptoms could be ALS?(i really hope and pray that its not)Any help/replies will be greatly appreciated. I think my tightness and stiffness in face,neck and lips could be me being stressed out over nothingI feel like i am having trouble swallowing food, but i read that that’s a sign of later stage of ALS.MY Physician did all the physical exams and said all my muscles are reacting normalMY biggest concern is the weakness in join calf. But than sometimes i also feel pain which shouldn’t be for ALS if internet is rightMaybe i just over reacting, i was told ALS doesn’t progress in a week.I just got married so i am really scared, so please helpis it a positive thing i have other issues like Vitamin D and thyroid issues which could cause some of these symptomsThank you in advance


Symptoms: Pain in joints,feeling weakness, face feeling stiff

Doctor: Hello,Thanks for contacting for an opinion.After having analyzed the history , it appears that it is not ALS. ALS often begins with muscle twitching and weakness in an arm or leg, or sometimes with slurring of speech. Eventually, ALS can affect your ability to control the muscles needed to move, speak, eat and breathe. ALS can’t be cured and eventually leads to death.The disease frequently begins in your hands, feet or limbs, and then spreads to other parts of your body. As the disease advances, your muscles become progressively weaker. This weakness eventually affects chewing, swallowing, speaking and breathing.ALS is inherited in 5 to 10 percent of cases. The other cases appear to occur randomly.So, in your case, the stiffness and weakness in lower limbs started with tingling sensation which can be attributed to diabetes and which can lead to peripheral neuropathy if sugar values are uncontrolled. Secondly, another differential diagnosis could be Viral myositis which can affect you after having contracted the virus in PAKISTAN, thereby causing muscle twitching and stiffness in various muscle groups.This is self limiting in most cases.Thirdly , the cause can be VITAMIN D deficiency and dyselectrolytemia per se which can often cause muscle cramps and twitchings along with occasional hypocalcemia or calcium deficiencyUnder no circumstances , it is ALS as thats a genetic disease and manifests very early to middle age in life and progression is rapid and involves all muscle groups without any symptom free periods.So you may visit your physician and discuss the options in detail and take an informed decision.I hope i have answered your query in detail,wishing you good health,regards


Comments / Follow Ups

Patient: okay thanks so it isn’t ALS or Parkins right?
i went to my family physician and he did physical exam and said the same thing its not ALS
he said its most likely thyroid issue
I just wanted to get a second opinion

Patient: also is Viral myositis curable?

Doctor: Hello,
Viral myositis is usually self limiting illness and the course may extend from 15 days to a month. it shall subside on its own.


Ask The Doctor
Dr. Suneel Sharman M.D.

Dr. Suneel Sharman M.D.

Dr. Suneel Sharman completed his residency in Family Medicine at the University of Toronto. He currently operates Infinity Health Centre, a walk-in-clinic in downtown Toronto.

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