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What Causes Persistent Weakness In The Lower Leg After Treating Acute Aortic Dissection?
Question: 6 months ago I had a descending aortic dissection. The blood supply to my leg was evidently cut off for about a day and and a half. As a result I was left with mononeuropathy. I had drop foot and my ankle was so weak my foot would roll. With much work I regained dorsaflexion (not quite fully but pretty close and still working on it). And my ankle is strong enough for me to walk easily. My question is this-although I have regained alot, I still don't have much feeling in my lower leg and foot. And more worrisome (to me) is I haven't seen any improvement since this happened. Is this something to worry about or am I just being too impatient. I was told by doctors that I would probably see a full recovery but that it would take months.
Brief Answer:
Recovery takes up to 12 months, however there is risk of some remains.
Detailed Answer:
I read your question carefully and I understand your concern.
Since you say that by now 6 months have already passed you do have some reason to be worried, you're not being impatient. It is possible that the damaged nerve might not regain full functions due to permanent damage by the loss of blood supply.
The doctors are right in saying that recovery takes months, nerve regeneration may last many months, even a year. So since you have been gradually improving there is plenty of motive to hope that you will return back to normal. However the most recovery happens during the first 6 months, so the longer symptoms persist the higher the risk that some loss of function due to only partial regeneration may remain.
I remain at your disposal for other questions.
Recovery takes up to 12 months, however there is risk of some remains.
Detailed Answer:
I read your question carefully and I understand your concern.
Since you say that by now 6 months have already passed you do have some reason to be worried, you're not being impatient. It is possible that the damaged nerve might not regain full functions due to permanent damage by the loss of blood supply.
The doctors are right in saying that recovery takes months, nerve regeneration may last many months, even a year. So since you have been gradually improving there is plenty of motive to hope that you will return back to normal. However the most recovery happens during the first 6 months, so the longer symptoms persist the higher the risk that some loss of function due to only partial regeneration may remain.
I remain at your disposal for other questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your reply Dr Taka. I have always assumed it was the peroneal nerve that was affected although the doctors never said that specifically . But just today I read about Tinel's sign. So I looked up where the peroneal nerve is and started tapping. I got the needles and pins sensation (or electrical feeling) down my leg and around my ankle but nothing on the top of my foot near the toes. I'm taking this as a good sign, do you agree? Can you tell I really really want this to heal? Am I grasping at straws?
Brief Answer:
Not a good prognostic sign.
Detailed Answer:
Hello again! Sorry for answering a little late but your question was when I had just gone to sleep (time differences with Europe).
Regarding Tinel's sign I am afraid that is not a good test to make predictions. It's sensitivity is low, for carpal tunnel syndrome which is where it's most used the sensitivity is only at 60% (detects only 60% of cases). For peroneal nerve sensitivity is even lower. So it's hard to make predictions based on that alone, even if it produced no needles and pins at all. In some cases it is present only proximally like in your case, not spreading distally, like in this case. If it was positive before and became negative now it might have been a good sign (but you have tested it only now it seems), but still not that significant.
Let me now if I can further assist you.
Not a good prognostic sign.
Detailed Answer:
Hello again! Sorry for answering a little late but your question was when I had just gone to sleep (time differences with Europe).
Regarding Tinel's sign I am afraid that is not a good test to make predictions. It's sensitivity is low, for carpal tunnel syndrome which is where it's most used the sensitivity is only at 60% (detects only 60% of cases). For peroneal nerve sensitivity is even lower. So it's hard to make predictions based on that alone, even if it produced no needles and pins at all. In some cases it is present only proximally like in your case, not spreading distally, like in this case. If it was positive before and became negative now it might have been a good sign (but you have tested it only now it seems), but still not that significant.
Let me now if I can further assist you.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you Dr Taka
I appreciate you answering my questions,
I appreciate you answering my questions,
Brief Answer:
You're welcome.
Detailed Answer:
You're welcome, hope things return back to normal soon.
You're welcome.
Detailed Answer:
You're welcome, hope things return back to normal soon.
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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