Brief Answer:
Possible autonomic dysfunction which commonly occurs but can be "missed."

Detailed Answer:

Hi,

Following a stroke, an affected limb often suffers from not just motor deficits, clearly obvious to patients, therapists, and even doctors- but other changes related to autonomic functions of the limb such as vasomotor control of the blood vessels and sweating apparatus.

That is what is most likely going on in your case which can explain swelling, erythema (redness), rash, and itching. Unfortunately, these sorts of changes are not quite as easy to reverse as other things such as weakness and precision of movement. Nevertheless, an autonomic function specialist may be able to conduct some specialized tests on the limb that can indicate the extent or severity of any autonomic dysfunction that may be present in the limb.

There are some medications and even physical therapy interventions that can be employed for this type of condition, however, the truth is that the success rate is somewhat low compared to the physical therapy success seen in more common rehabilitation of an affected limb after stroke.

One thing that can be tried is to use ACE WRAPS on the foot and leg with the swelling or perhaps compression stockings which can apply more uniform and constant compression. Another thing that could help is electrical stimulation or some form of neuro-rehabilitation to the right leg likely applied by the physical therapist.

Of course, with the stroke being 4 years ago and this condition having cropped up, supposedly within a period of time following the stroke it may be increasingly difficult to retrain the autonomic function of that limb but I believe it is worth an effort. I think a period of time of no less than 12 months should be considered in such a case to see if improvements occur.

I hope my answer helps.

Regards

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