Jaw fatigue

[ivan 2]

Type 2 on insulin for one year and stents after a coronary.
Well controlled high sugar but rather common episodes of hypo.
Extreme fatigue of chewing muscles that disappears after some rest.
Neurological exam was OK but the doctor did not pay much attention to chewing fatigue, although I suggested possible neurological disorders (amyotrophic lateral sclerosis,multiple sclerosis, myasthenia gravis).
I suspect myasthenia gravis (any permanent nerve damage would not recover after rest), but too tired of everything for any further clinical exams.
Curious if any of you with diabetes have experienced this symptom (extreme jaw fatigue when chewing).
Thank you

 

[kitedoc]

Hi @ivan 2, From my reading as a T1D, not as professional advice or opinion:
What you describe does not fit anything I have heard related to diabetes. Not that i have total knowledge of course!!
I assume it was your GP who fielded your question and did the neurological exam?
And I assume your coronary artery stents were put in via a puncture in one or both groin arteries?
Given where the wires they use to place the stents, squirt dye etc are travelling, up near the collar bones etc, it still seems far away from the jaw but it may be worth just checking with your cardiologist.
Otherwise isolated muscle tiredness needs a specialist to divine what might be happening - neurologist might be the first cab off the rank.
You have made your own enquires about possible causes and you may keep worrying if your jaw muscles continue to cause you trouble. You have to be able to eat after all. What does your GP not understand !!

 

[ivan 2]

Thank you so much.
Everything was just perfectly under control since March last year, was able to walk 5 miles every day.Then about a month ago it started with jaw fatigue and also neck extensor muscle weakness, causing ``dropped head`` almost to the chest, but miraculously, it has improved by itself.
And it was a specialist in neurology who examined me.
Will wait for some time and see what happens, then ask for help. If any systemic neurological disease started this way, there is no cure anyway.

 

[kitedoc]

Hi @ivan 2, I would have thought that the neurologist would have suggested a follow up in so many months to review ?
I read recently that there is a new treatment that extends the early phase of ALS more than any other treatment so far.
Something to do with copper in the formulation. But finger crossed it all settles for you.

 

[SimonCrox]

As you say, weak muscles that get better with rest suggest myaesthenia gravis (MG), but I am not giving a diagnosis.. The weak neck muscles which got better with a treatment for MG were something that we used to test for - I did neurology for 1 year (1986); folk would generally have slurred speech, poor swallow and double vision, particularly towards end of day. But you do give a good history of a very weak neck.
Apparently MG can be transient, rarely:-
https://jnnp.bmj.com/content/75/9/1363.1

Have they done the anti-acetycholine receptor antibody blood tests? Did they look to see if they could fatigue your muscles - eg flap your arms 20 times and see if it is difficult to lift them up?

If it is getting better, that is great news.

Another condition can sometimes cause pain in jaw on chewing (not really weakness), which is called jaw claudication. So it might be worth checking the plasma viscosity.

I agree that if you had something like MND/ALS/MS, then the weakness would not behave like this, as you say.

Muscles get a bit tired if running hyeprglycaemic, but I have never seen this give a weak neck

Hope it all continues to get better
Best wishes

 

[ivan 2]

SimonCrox

Thank you so much.Everything you said makes sense and very encouraging, too.Such an informative comment.
Will probably visit my neurologist again.He did not pay much attention to jaw weakness because everything else was perfectly normal, no weakness elsewhere.
You are of great help.Thanks again.