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Signs and Symptoms

Signs and symptoms can progress relatively quickly once they appear. They typically start in the feet and/or hands and spread upward to the legs, arms and trunk. At first they may include:

  • Tingling or pins-and-needle sensations
  • Numbness
  • Tenderness
  • Weakness, especially in the legs
  • Muscle spasms
  • Loss of coordination
  • Loss of reflexes

More serious symptoms, some of which may require emergency medical assistance, include:

  • Paralysis
  • Difficulty breathing and/or swallowing
  • Abnormal heart rate

In most cases, symptoms develop over hours to days and may continue to worsen for up to a month, after which they slowly resolve. Up to 30% of those affected may still have some lingering weakness after 3 years, and a small percentage may have a relapse years later.

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