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Posted by CCF Neuro MD on July 10, 1997 at 14:16:37:
In Reply to: muscle pain and fatigue, legs and arms posted by leigh on July 01, 1997 at 03:43:55:
: My brother-in-law, for the last several months, has been experiencing
severe muscle pain and fatigue in his legs. It has now spread into his arms. He
Went for a battery of tests, including some exercising ones, with no
diagnosis or results. Here is his background: he is 33, a ranch hand,
rides horses all day, has been exposed to all outdoor environments, in-
cluding ticks and weed killers. What should he be tested for? I worry
because he lives in a very small town where I don't imagine the most
experienced doctors practice. Please e-mail ***@****.
Reading your brother's symptoms, a variety of rare and somewhat more common neuromuscular disorders come to my mind. These include some rare enzyme deficiencies, myasthenia gravis and related neuromuscular junction diseases, inflammation of muscle, and compressive and non-compressive radiculopathies, amongst others. A connection with ticks and weedkillers, although improbable, can not be ruled out. If symptoms are progressive, significantly disabling, or sufficiently bothersome, your brother should be seen by a neuromuscular specialist in an academic neurology department near you for a complete diagnostic work-up.
If you live in the Cleveland area, I strongly recommend that your brother see any of the neuromuscular specialists at the Cleveland Clinic (Dr. Hiroshi Mitsumoto, Dr. Kerry Levin, or Dr. Robert Shields), and thereafter also have an EMG peformed at the Clinic, if indicated. Drs. Wilbourn, Levin and Shields perform EMG examinations. These doctors I mention are known worldwide for their expertise in the diagnosis and management of neuromuscular disease. You could call (800)223-2273 or (216)444-2200 and ask for the neurlogy appointments desk for an appointment.
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