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Is weakness in left leg in an elderly man a cause for concern?

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Posted on Tue, 17 May 2016
Question: My Dad has weakness in one leg and when he tries to stand unaided he falls. He has literally gone overnight from a normal walking person to using a zimmer frame and aides by one person to walk. Bood tests CT scan have all been reported as normal. He has had a hospital stay with many tests and all tests are normal. Any ideas please my dad is only 68 and I hope he can get his mobility back and drive again. The falls worry me as he keeps hurting himself. He saya his leg aches its only his left leg feels weak examination shows power 4/5. He can sit and move leg on his own his thigh is tender like muscular ands says his knee feel like it gives way but not sure if it is his knee or leg he cant pinpoint it. Knee xray shows mild osteoarthritis nil else and doppler scan is entirely normal. Physio is not helping. Please please help I just want my dad back what else can I do? Stroke has been ruled out
doctor
Answered by Dr. Shafi Ullah Khan (1 hour later)
Brief Answer:
TIA likely

Detailed Answer:
Thank you for asking

I read your question and i understand your concern. Its not stroke but it sure is Transient ischemic attack as the sudden loss of mobility an dinability to stand with weakness in one side of the body is attributed to transient ischemic attack, an early warning for the imminent stroke.

Your father needs to be started on prophylactic antithrombotic therapy like clopidogrel etc and low doses aspirn. Meanwhile all efforts to keep him mobilised, physiotherapy exercises, and also work up to rule out narrowing of carotids via carotid artery doppler etc. Apart from it supportive therapy for arthritis with pain killers and adequate nutritional rehab should be high priority. Wait and see. TIA resolves very soon but needs immediate measures to prevent imminent stroke.

I hope it helps. Take good care of your father and dont forget to close the discussion please.

Regards
Khan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Shafi Ullah Khan (3 minutes later)
My dad was on propranolol for many years 10 years plus then doctor suddenly stopped them do you think leg weakness could be related to that? No tests have shown a TIA doppler is normal. If it is a TIA when should dad get his mobility back? Dad is on 300mg of Aspirin but it changes Monday to Clopidpgrel. Dad was on propranolol for severe headaches it just seems odd that he stopped them then 4 days later he got this problem
doctor
Answered by Dr. Shafi Ullah Khan (4 minutes later)
Brief Answer:
Need evaluation and complete neurological examination

Detailed Answer:
Thank you for getting back to me

Now that you mentioned use of propanol for migraine headache, let me sort out another variant of migraine, which is called acephalgic migraine, it presents like stroke symptoms as unilateral weakness and sudden loss of mobility. Its basically a migraine and needs treatment and shift to other options than propranolol if not adequate. Talk these options with your neurologist and let them decide what is best for your DAD. Had it been TIA your dad should have been on his feet in a day or two.

I hope it helps.
Regards
Khan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shafi Ullah Khan (2 minutes later)
This has been 4 weeks he doesnt get headaches migraine now he is fine but tablets stopped had no headaches just this leg weakness where his legs just give way with no warning
doctor
Answered by Dr. Shafi Ullah Khan (6 minutes later)
Brief Answer:
Needs work up and management accordingly

Detailed Answer:
Thank you for getting back to me

Limb weakness is a whole neurology and it needs a complete neurological correlation. I have provided you two major lines of possibilities. Apart from it guessing any further will be shooting blanks. Get your father to a neurologist and let them rule out other possibilities.

if all clear this immobility will be attributed to osteoarthritis , which is age related articular degeneration of the joints causing reduced mobility and will be treated with pain killers and supportive care.

I hope it helps. Regards
Khan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Shafi Ullah Khan

General & Family Physician

Practicing since :2012

Answered : 3613 Questions

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Is weakness in left leg in an elderly man a cause for concern?

Brief Answer: TIA likely Detailed Answer: Thank you for asking I read your question and i understand your concern. Its not stroke but it sure is Transient ischemic attack as the sudden loss of mobility an dinability to stand with weakness in one side of the body is attributed to transient ischemic attack, an early warning for the imminent stroke. Your father needs to be started on prophylactic antithrombotic therapy like clopidogrel etc and low doses aspirn. Meanwhile all efforts to keep him mobilised, physiotherapy exercises, and also work up to rule out narrowing of carotids via carotid artery doppler etc. Apart from it supportive therapy for arthritis with pain killers and adequate nutritional rehab should be high priority. Wait and see. TIA resolves very soon but needs immediate measures to prevent imminent stroke. I hope it helps. Take good care of your father and dont forget to close the discussion please. Regards Khan