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Dr. Andrew Rynne

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What causes numbness in the body, leg weakness and sudden spontaneous fall while walking?

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Dr. Ishu Bishnoi

Neurologist, Surgical

Practicing since :2007

Answered : 830 Questions

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Posted on Wed, 16 May 2018 in Brain and Spine
Question: I just had a falling spell called "drop attack". I've had them a few times in the past but I haven't had one in about three years until today. I've been checked in the past for any heart problems and I've been examined for seizures. All the tests were normal. I had a Doppler test on my legs to check for blockages and it was normal. I had been lying down and got up to go to the kitchen. I had started back to the bedroom when I started feeling numb and tingly all over. My legs just felt very weak and I dropped to the floor. I can get back up immediately after I fall and I don't feel light headed or lose consciousness. It's just a numb feeling all over then a weakness and I can't remain standing. Do you know of anything that could cause this? Heart problems and seizures have been ruled out.
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Answered by Dr. Ishu Bishnoi 1 hour later
Brief Answer:
Drop attacks causes

Detailed Answer:
Hi XXXX, thanks for asking from HCM.


I can understand your concern. You are suffering from "drop attacks" for long time. As seizures (most common cause) have been already ruled out, we are left with few differential diagnosis. These are

- Autonomic dysfunction or hypotensive attacks - Sudden lowering of BP due to autonomic dysfunction can cause episodes of fall. It can be due to autonomic neuropathy following diabetes/alochol/age related/B12 deficiency/drug induced. To confirm the diagnosis, your autonomic system should be checked. Consult a neurologist for it. If it is impaired, nerve conduction velocity can be done to confirm diagnosis of neuropathy.

- Functional limb weakness - The drop attacks occur mostly due to leg that is normally weak, ‘giving way’. Although these may be just described as falls, its often the case that the person feels a slight weakness and the next thing they know they are on the ground having fallen. The leg weakness could be due to neuropathy/spinal cord compression. MRI spine and NCV will help in confirming the diagnosis.

- Heart and vascular disease have been already ruled out.

- Sudden sleep attacks or narcolepsy. Uncontrolled, sudden sleep attacks or sleep paralysis can cause drop attacks. Confirmation is be sleep analysis and EEG. The neurologist, who is sleep expert, will rule out these possibilities.

- Dissociative dysfunction - It is one pf psychological cause of drop attacks. It can be considered only after ruling out every other possibility. A psychiatrist is needed to confirm the diagnosis.

I hope it will help you. You can send me detailed evaluation as per above diagnosis. I will help you further. If you any doubt, do let me know.

Thanks. Take care.
Above answer was peer-reviewed by : Dr. Yogesh D
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Follow up: Dr. Ishu Bishnoi 19 hours later
Today I had a dizzy spell but didn't fall this time. I checked my blood pressure. Sitting down it was 147/67. I stood up and took it and it was 93/50. Could this sudden fall in blood pressure cause the drop attack I had yesterday? I didn't think to check my pressure yesterday when I fell so I don't know if it was low or not after the fall. Is this a symptom of autonomic dysfunction?
doctor
Answered by Dr. Ishu Bishnoi 4 hours later
Brief Answer:
Autonomic dysfunction

Detailed Answer:
Hi XXXX, welcome back.


You have correctly diagnosed it. There is too much fall in blood pressure on standing erect (around 50mm Hg in systolic blood pressure and 17mm Hg in diastolic blood pressure). In a healthy human being, it should be not more than 10-20 mm Hg fall.

You must consult a neurologist, who will check your autonomic system completely and will advise you investigations as I mentioned in previous answer. It will confirm it and find the cause.

Till then, you must

- Avoid sudden standing. Try to hang your lower limbs first for few seconds, then gradually stand erect with support.

- Drink plenty of fluids (juices/water).

- Do exercise to increase your basal tone.

Finally treatment can be started after confirming the diagnosis. Hope you got my point.
If you have any doubt, do let me know.
Thanks. Take care.
Above answer was peer-reviewed by : Dr. Yogesh D
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