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What Causes Persistent Numbness In The Leg In A Person With Diabetic Neuropathy?
Question: i have diabetic peripheral and sensory neuropathy it is so severe I can not stand. the numbness doesnt seem quite as bad as it has done but I have been like this for 3 months. i cant use my legs as they feel so weak around my knee area. i have pain in my legs and my fèet feel numb. will i ever be able to walk or at least stand again and if so what can i do. my neurologist says nothing can be done and has just left me. myself and family are really upset that we see no light at the end of the tunnel
Brief Answer:
Neuropathy treatment
Detailed Answer:
Good day,
Sorry to hear about your symptoms. Please do not worry. Diabetic peripheral neuropathy can be effectively treated . First of all, diabetes control should be optimised. Second, we need to inveatigate alternate causes of neuropathy other than diabetes. If you drink alcohol or smoke, you need to stop it ASAP
You may need a thyroid function test, VDRL, Vitamin B12 test etc along with toxic screening.
You may also need a combination of neuropathy medications. Lyrica and Gabapentin and excellent drugs. There are many other drugs. Please meet an endocrinologist ( or a diabetes multi disciplinary team) if available in your area.
Neuropathy treatment
Detailed Answer:
Good day,
Sorry to hear about your symptoms. Please do not worry. Diabetic peripheral neuropathy can be effectively treated . First of all, diabetes control should be optimised. Second, we need to inveatigate alternate causes of neuropathy other than diabetes. If you drink alcohol or smoke, you need to stop it ASAP
You may need a thyroid function test, VDRL, Vitamin B12 test etc along with toxic screening.
You may also need a combination of neuropathy medications. Lyrica and Gabapentin and excellent drugs. There are many other drugs. Please meet an endocrinologist ( or a diabetes multi disciplinary team) if available in your area.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
do you see my dad will be able to stand again and even walk?
Brief Answer:
Multi disciplinary approach
Detailed Answer:
It is a difficult question to answer with out examining him. However, it may be possible for him to stand and walk with a combination of phsysiotherapy and drugs. You may also require help from occupational therapist
Multi disciplinary approach
Detailed Answer:
It is a difficult question to answer with out examining him. However, it may be possible for him to stand and walk with a combination of phsysiotherapy and drugs. You may also require help from occupational therapist
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
To pinpoint the cause
Detailed Answer:
If he has had permanent irreversible damage of nerve and secondary muscle atrophy, it may be a little difficult, but not impossible. Please be aware that any such treatment takes time. In the interim, get his sugars under control, preferably with insulin . As you correctly pointed out, pin pointing the exact cause is the crucial step.
To pinpoint the cause
Detailed Answer:
If he has had permanent irreversible damage of nerve and secondary muscle atrophy, it may be a little difficult, but not impossible. Please be aware that any such treatment takes time. In the interim, get his sugars under control, preferably with insulin . As you correctly pointed out, pin pointing the exact cause is the crucial step.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
numbness seems to be resolving a bit and legs keep twitching like the muscle and he is now get pain is this a good or bad sign
Brief Answer:
? resolving
Detailed Answer:
Resolving numbness is a good sign and may indicate partial recovery. Muscle twitchings could be due to myoclonus or due to lower motor neuron disease.
However, Ongoing Pain is a bad sign. Is he able to feel the ground/footwear ? .
? resolving
Detailed Answer:
Resolving numbness is a good sign and may indicate partial recovery. Muscle twitchings could be due to myoclonus or due to lower motor neuron disease.
However, Ongoing Pain is a bad sign. Is he able to feel the ground/footwear ? .
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
yes he can feel he doesnt have motor neurone disease does he he has no upper limb problems
Brief Answer:
great
Detailed Answer:
that is good to hear. If he is able to feel the ground, then it is a good sign. With a combination of treatmet, hopefully he will improve/recover.
great
Detailed Answer:
that is good to hear. If he is able to feel the ground, then it is a good sign. With a combination of treatmet, hopefully he will improve/recover.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
so you dont think it motor neurone disease
Brief Answer:
Need clinical examination to answer
Detailed Answer:
only a clinical examination can answer that question. Your neurologist would have done a thorough clinical examination. There are clincal clues.
Need clinical examination to answer
Detailed Answer:
only a clinical examination can answer that question. Your neurologist would have done a thorough clinical examination. There are clincal clues.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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Answered By: Dr. Erion Spaho
Neurologist, Surgical+ Additional Details+ Update Reports
Hi please let me start from the beginning.
Dad approximately 3 months tried to get up and simply couldn’t. Dad has always been an independent man with no mobility problems. We took Dad to the hospital who thought Dad had had a TIA. After assessment TIA was ruled out.
Dads main symptoms were severe pain in left thigh and leg and when he tried to stand up his legs would just collapse underneath him. Dad does have some numbness in his leg. This all started in his left leg but has now developed to the right leg (right leg is now much worse than the left with exactly the same symptoms, numbness, pain and legs collapse underneath him. Numbness in left leg has now resolved but still has it in his right leg. The numbness in right leg seems to be getting better but Dad can not stand as legs just wont hold my dad. Dads feet are always stone cold and he says he cant tell himself without touch whether both feet are hot or cold, recently dads feet are a little warmer. Dad has no upper limb symptoms.
At the moment Dad can’t get from a sitting to standing position yet his left leg now has full power and can leg raise with full range of movement. The right leg however he can not lift at all but can move it and has power in it, Dads left leg was like this at first but now the leg seems to be resolving though Dad can still not walk or stand.
We have had a follow up appointment with the Stroke Team who have now discharged Dad as they say his condition is not stroke related.
We have seen a Neurologist and are awaiting EMG studies plus MRI scan (had MRI scan now awaiting results) and Occupational Therapy input. Neurologist gave us no hope what so ever and said there is no treatment and reversing what is wrong with Dad. I am sure medicine these days there must be something.
There were no reflexes with dad but they do seem to be coming back a bit and you can see dads thighs like flutter.
Dad is currently in hospital and he is on vitamin drips
Please find below the letter we got from the Neurologist:
Diagnosis: likely diabetic motor sensory neuropathy
Thank you for referring this 68 year old right handed gentleman to the Neurology clinic. He has had Diabetes since 2000. His control was previously poor though has improved in the last 9 months. Mr Bridge has a previous history of osteomyelitis for which he was treated long term antibiotics (18 months of antibiotics). He now describes a 3 month history of progressive weakness of both legs. He also described numbness in the legs. His arms bowel bladder speech and swallowing is unaffected.
On examination today his cranial nerves were unremarkable. Examination of limbs revealed normal tone. Power was normal in both arms and legs. Hip flexion was reduced to 3/5 bilaterally. Reflexes were absent in the legs but present in the arms. Sensation to pinprick was reduced distally in the legs but was present in the arms. Vibration sense was absent up to the hips. There were no fasciculation’s visible.
I suspect this gentleman has quite a severe axonal motor sensory neuropathy secondary to his diabetes. I have explained that this is not a treatable condition but we need to exclude any more treatable condition but we need to do some further investigations to exclude anymore treatable causes. I am arranging MRI scan of lumbar spine to make sure there is no cord pathology or nerve root compression and some nerve conduction studies to quantify the extent of his nerve damage.
Questions:
1. Do you have any idea what is wrong with my Dads legs?
2. How can we get Dad XXXXXXX even with a Zimmer (Dad still falls with a frame)
3. Do you think this condition can resolve or get better?
4. If Dad can move legs freely whilst sat down why can he not stand up without legs collapsing or him falling?
5. What is axonal motor sensory neuropathy and do you agree this is what is wrong? Can it get any better?
6. What treatable causes are there?
7. Can dad walk again even with help of a zimmer?
8. This isnt motor neurone disease is it I am so upset and worried
9. Dad says his feer are numb but can feel them if we touch them he has good pulses in feet. Is this a bad sign that dad wont walk again or stand or can this be improved?
Answered By: Dr. Erion Spaho
Neurologist, Surgical+ Additional Details+ Update Reports
Hi please let me start from the beginning.
Dad approximately 3 months tried to get up and simply couldn’t. Dad has always been an independent man with no mobility problems. We took Dad to the hospital who thought Dad had had a TIA. After assessment TIA was ruled out.
Dads main symptoms were severe pain in left thigh and leg and when he tried to stand up his legs would just collapse underneath him. Dad does have some numbness in his leg. This all started in his left leg but has now developed to the right leg (right leg is now much worse than the left with exactly the same symptoms, numbness, pain and legs collapse underneath him. Numbness in left leg has now resolved but still has it in his right leg. The numbness in right leg seems to be getting better but Dad can not stand as legs just wont hold my dad. Dads feet are always stone cold and he says he cant tell himself without touch whether both feet are hot or cold, recently dads feet are a little warmer. Dad has no upper limb symptoms.
At the moment Dad can’t get from a sitting to standing position yet his left leg now has full power and can leg raise with full range of movement. The right leg however he can not lift at all but can move it and has power in it, Dads left leg was like this at first but now the leg seems to be resolving though Dad can still not walk or stand.
We have had a follow up appointment with the Stroke Team who have now discharged Dad as they say his condition is not stroke related.
We have seen a Neurologist and are awaiting EMG studies plus MRI scan (had MRI scan now awaiting results) and Occupational Therapy input. Neurologist gave us no hope what so ever and said there is no treatment and reversing what is wrong with Dad. I am sure medicine these days there must be something.
There were no reflexes with dad but they do seem to be coming back a bit and you can see dads thighs like flutter.
Dad is currently in hospital and he is on vitamin drips
Please find below the letter we got from the Neurologist:
Diagnosis: likely diabetic motor sensory neuropathy
Thank you for referring this 68 year old right handed gentleman to the Neurology clinic. He has had Diabetes since 2000. His control was previously poor though has improved in the last 9 months. Mr Bridge has a previous history of osteomyelitis for which he was treated long term antibiotics (18 months of antibiotics). He now describes a 3 month history of progressive weakness of both legs. He also described numbness in the legs. His arms bowel bladder speech and swallowing is unaffected.
On examination today his cranial nerves were unremarkable. Examination of limbs revealed normal tone. Power was normal in both arms and legs. Hip flexion was reduced to 3/5 bilaterally. Reflexes were absent in the legs but present in the arms. Sensation to pinprick was reduced distally in the legs but was present in the arms. Vibration sense was absent up to the hips. There were no fasciculation’s visible.
I suspect this gentleman has quite a severe axonal motor sensory neuropathy secondary to his diabetes. I have explained that this is not a treatable condition but we need to exclude any more treatable condition but we need to do some further investigations to exclude anymore treatable causes. I am arranging MRI scan of lumbar spine to make sure there is no cord pathology or nerve root compression and some nerve conduction studies to quantify the extent of his nerve damage.
Questions:
1. Do you have any idea what is wrong with my Dads legs?
2. How can we get Dad XXXXXXX even with a Zimmer (Dad still falls with a frame)
3. Do you think this condition can resolve or get better?
4. If Dad can move legs freely whilst sat down why can he not stand up without legs collapsing or him falling?
5. What is axonal motor sensory neuropathy and do you agree this is what is wrong? Can it get any better?
6. What treatable causes are there?
7. Can dad walk again even with help of a zimmer?
8. This isnt motor neurone disease is it I am so upset and worried
9. Dad says his feer are numb but can feel them if we touch them he has good pulses in feet. Is this a bad sign that dad wont walk again or stand or can this be improved?
Brief Answer:
Answers
Detailed Answer:
Hello, Sorry for the delay.
1)Your dad's issues are very well described by the neurologist in the summary. He has neuropathy.
2)With Zimmer frame, he may be able to stand and walk with OT and Physio help.
3) This is a difficult question. We need to look at nerve condution study before answering .
4)He seems to have problems lifting legs against gravity. Hip flexion seems to be weak. Hip flexion ( movements of thighs and hips) are supported while sitting and hence may be able to move his legs while sitting ( sideways). But even while sitting, he may find difficulty holding legs straight or lifting against gravity.
5)Axonal neuropathy is where the middle axon is degenerated. This is a nasty one and recovery is difficult. Need to do a nerve conduction to eclude this variety of neuropathy,
6) Treatable causes are spine problems, hypothyroidism, Viatmin deficiencies etc.
7) I answered this question. Please see answer 2.
8) Need to wait until nerve conduction test. Motor neuron disease seems unlikely as your neurologist mentioned there are no fasciculations.
9) With absence of vibration till hips, he seems to have quite severe neuropathy. But still may be abke to appreciate some forms of touch especially crude touch ( touch with presssure). Improvement and prognosis can be decided only after full work up.
Answers
Detailed Answer:
Hello, Sorry for the delay.
1)Your dad's issues are very well described by the neurologist in the summary. He has neuropathy.
2)With Zimmer frame, he may be able to stand and walk with OT and Physio help.
3) This is a difficult question. We need to look at nerve condution study before answering .
4)He seems to have problems lifting legs against gravity. Hip flexion seems to be weak. Hip flexion ( movements of thighs and hips) are supported while sitting and hence may be able to move his legs while sitting ( sideways). But even while sitting, he may find difficulty holding legs straight or lifting against gravity.
5)Axonal neuropathy is where the middle axon is degenerated. This is a nasty one and recovery is difficult. Need to do a nerve conduction to eclude this variety of neuropathy,
6) Treatable causes are spine problems, hypothyroidism, Viatmin deficiencies etc.
7) I answered this question. Please see answer 2.
8) Need to wait until nerve conduction test. Motor neuron disease seems unlikely as your neurologist mentioned there are no fasciculations.
9) With absence of vibration till hips, he seems to have quite severe neuropathy. But still may be abke to appreciate some forms of touch especially crude touch ( touch with presssure). Improvement and prognosis can be decided only after full work up.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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