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What Causes Sudden Onset Of Weakness In Legs?

Posted on Fri, 3 Jun 2016

Question: My Dad has weakness in both his legs 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. Blood 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 says his legs ache and feel very weak examination shows power 4/5 right leg and 3/5 left leg. He can sit and move leg on his own his thigh is tender like muscular (been told this is like muscle wasting) 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. I am worried sick it is something like motor neurone disease please help me

Answered by Dr. Ajay Panwar (2 hours later)

Brief Answer:
Please tell some details:

Detailed Answer:
Hi XXXXXXX
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist, here to answer your query.

I understand your concerns well and I shall do my best to address these well,however,I need to know some details for the same-
1)Since when he is having these symptoms?Are they progressive or static?
2)Is there any weakness in upper limbs as well?
3)Any difficulty in passing urine?retention of urine or incontinence?
4)Any history of loss of hot,cold or touch sensations?
5)Any history of stiffness in limbs or rigidity?
6)Any history of tremors?
7)Any history of abnormalities in eye movements,speaking or swallowing?

If you have his medical documents/case summary available with you,please upload them as scanned documents,so that I can make a better impression.

I shall be glad to have you in follow-up with details.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ajay Panwar (28 minutes later)

Hi I have no reports sorry. Dad started left leg now progressed to weakness in right. There are no upper symptoms. No urinary symptoms, no less of sensation but feet do go white and get very cold but when rub them they come back to normal. No stiffness or rigidity. No tremors and no other abnormalities eyes speech or swallowing. He is a type 2 diabetic and did drink 3 bottles whisky a week but this has now completely stopped for 6 weeks
I am worried to death about Motor Neurones Disease do you see this is a case of this?

Answered by Dr. Ajay Panwar (17 hours later)

Brief Answer:
NCV/EMG/MRI SPINE

Detailed Answer:
Hi XXXXXXX
Thanks for being in follow-up and providing further details.

I reviewed my previous discussion with you regarding your father's illness.This weakness can either be a neuromuscular complication of Diabetes or related to spine degeneration.
I suggest that he should be taken up for Nerve conduction studies and electromyography. Also,MRI of spine needs to be done to rule out degeneration of spine and to exclude the possibility of radiculopathy.

However,as I mentioned previously, a meticulous neurological examination will help in this regard.If possible,please take him to a neurologist in person.

Hope that helps.If you have some further questions,I shall be glad to have you in follow-up.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ajay Panwar (15 minutes later)

Can he get mobility back if it anything you have mentioned and do you see its not mnd?
Dad has neurology appointment 7 may cant get anything any quicker what can we do to help dads mobility

Answered by Dr. Ajay Panwar (8 hours later)

Brief Answer:
Neurological examination will guide the management.

Detailed Answer:
Hi XXXXXXX
Thanks for being in follow-up.

I understand your situation and I have my best wishes for your dad,however,I am sorry to say that at this point of time,without a neurological examination and a proper diagnosis-its premature to say anything about management.

MND is a diagnosed on physical examination, supported by NCS/EMG. No one can say if its MND or not, just on the basis of history.

However,in background of Diabetes, neuromuscular complications of Diabetes is the first differential.Also,degenerative spine should be ruled out.

Meanwhile,a physiotherapist may be of help in helping her mobility.

Hope that I have answered your query.If you have some further questions,I shall be glad to answer else please close the thread,rate it and write a review.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ajay Panwar (22 hours later)

Dad has had Physio assessment today. They say dads quadriceps are weak. They dont know why so been referred for a neurology appointment. They say dad has good reflexes. What conditions could this be please? He has good pulses also

Answered by Dr. Ajay Panwar (10 hours later)

Brief Answer:
Please upload their assessment sheet.

Detailed Answer:
Hi XXXXXXX
Thanks for being in follow-up.

I need to view the examination sheet to make a comment.Its because just on basis of 'quadriceps are weak,reflexes are good'-its hard to make any interpretation.

If possible,Please scan and upload the document on which they wrote their assessment notes.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ajay Panwar (3 hours later)

I dont have no assessment sheet sorry

Answered by Dr. Ajay Panwar (1 hour later)

Brief Answer:
Diagnosis needs physical examination.

Detailed Answer:
Hi XXXXXXX
Thanks for being in follow-up.

I am afraid to say that its difficult to comment upon the diagnosis here,without a neurological examination.

If you have any further question,you are most welcome in follow-up.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar