My mother suffered a stroke in Oct 2009; she is 80, and had a total hemi-paresis on the right side. She received TPA immediately in the hospital that reversed her paralysis almost completely, with only minor weakness in her right arm, and was able to walk and use her arms almost as before the stroke. In Feb or so we noticed she constantly held her right arm bent up against her side, but could straighten it when we pointed that out to her, and she tended to use it less and less. Her arm has gotten progressively weaker over months to the point where it is now completely useless and her hand is curling into a fist, though she can try to straighten fingers with her other hand. She also tends to lean to the right when walking, and we have to support her while she walks so she won t fall. Mentally, she has poor short term memory, but sometime is she sharp as a tack! Her speech itself is fine. Her neurologist says there s no sign of another stroke, though he says it s not impossible. All her doctors are relating this right arm paralysis to her original stroke, but I think there may have been a second one, maybe a mini-stroke that we didn t notice. She had an MRI recently to rule out a cervical problem. She sometimes has right leg weakness as well, but it goes away. In short, she was much better right after the stroke then she is now, and she is very much incapacitated. Besides another stroke, what else could be causing this arm-degeneration? If she did have another stroke, is there any hope for improvement? And just to rule it, do you think it might be hyperkalemia? I just read how that can cause paralysis; she takes K-Lor, a potassium supplement, to counteract her Lasix, as her legs are often swollen.