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Wrist and hands are weak. Food gets stuck in esophagus. Was treated with vibramycin for Lyme disease. Suggest?

Nov 2013
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Practicing since : 1994
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I am loosing use of my right hand and wrist and my left hand. The right wrist is excruciatingly painful. I'm also falling frequently. At least once a week I choke on food or it gets stuck in my esophagus, also I'm Dropping things because of loss of grip. My lab test were essentially normal: CRP, RA, Sed Rate, CBC, XXXXXXX and CMP. In 2008 I was bitten by a Lyme Disease tick. I had the classic bullseye. I was treated for a month with Vibramycin or Tetracycline for a month. No lab test have been done. My PCP says I was adequatey treated for Lyme so I don't need Lyme Studies. My immune system has always been crappy. I have had mumps encephalitis. malaria, CMV, whooping cough, and the usual childhood diseases. I've had 3 friends die with ALS so I'm a little paranoid about this.
Posted Sun, 18 Aug 2013 in Brain and Spine
Answered by Dr. Sudhir Kumar 7 hours later
Thank you for posting your query.

I can understand your anxiety about ALS, as you have had three friends with the same disease. However, ALS is an uncommon disease, and your symptoms are not typical of ALS.

In ALS, pain is not a presenting feature. In ALS, along with weakness, there is wasting (thinning) of muscles, and fasciculations (muscle twitchings) are common. Sensory system (ability to perceive touch and pain) is not affected. Similarly, bladder and bowel functions are normal. Finally, to allay your fears, an EMG (electromyography) study of muscles would be required to 100% rule out ALS.

In my opinion, you could be having neuropathy, such as carpal tunnel syndrome, and it can be diagnosed by nerve conduction studies.

I hope it helps.
Please get back if you have any more queries.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist
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