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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What causes weakness in legs despite having normal blood reports and CT scan?

Answered by
Dr.
Dr. Muhammad Hanif

General & Family Physician

Practicing since :2009

Answered : 2369 Questions

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Posted on Mon, 6 Jun 2016 in Bones, Muscles and Joints
Question: My Dad started with his left leg giving all the time feeling like it was his knee and weakness in leg. This has now progessed to the right leg which I think is because right leg been compensating for left leg. When dad 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) and 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. Physio says he has quadriceps problems weakened and muscle tone weak

I am.worried sick its motor neurone disease
Dad also has developed low blood pressure and dizziness
doctor
Answered by Dr. Muhammad Hanif 7 hours later
Brief Answer:
It is loss of control of neurons over the muscle movements and tone!!!

Detailed Answer:
I welcome you here at HCM and happy to assist you for your dad's genuine health concerns. I have carefully gone through the case details and can well establish the seriousness of the issues going on there with your Dad.

It actually is due to senile changes and he has got loss of neural tone on the muscles of his limbs. Under normal circumstances in a healthy person, the neurons have a constant nourishment signals and a resting muscular tone keeping control on the body muscles.

It is less likely to be a stroke as this is generalized muscular weakness. This is neurologic defect and sometimes it is added with the bone diseases like Osteoporosis that makes things difficult. It aggravates the weakness and mobility is reduced.

Now he needs a thorough evaluation by a Neurologist for proper management. He will need to check his vitamin levels like Vit. D, B12 and if needed can be supplemented for. Also, he may add neuronal-nourishing multivitamins and minerals like zinc, potassium and sodium and other micronutrients. He may also add some neuronal nourishment medications to improve the muscle conditions.

The way our body utilizes energy is controlled by thyroid and it is mandatory to rule that out too. Thyroid function tests are needed to be done from a lab by his Primary care Physician. Low levels of thyroid hormones causes the undue and sudden weakness in body and fatigue. Ask his Neurologist to rule out Guillain barre syndrome and Myasthenia gravis that are the two important causes of the weakness and finally paralysis in limbs. He will also need to go for nerve and muscle conduction studies on your dad.

Taking caffeinated drinks and alcohol in excess also may cause nerve and muscle issues. It is needed to be dealt with care.
Diabetes and high blood pressure also causes the leg muscles weak. We need to control these diseases too.

Hope it helps. Please feel free to ask for any kind of help if needed. My direct link is: tinyurl.com/drhanifmd
You can upload his aforementioned labs when ready if you need a review and my opinion on them.

Regards!
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Muhammad Hanif 8 hours later
Can diabetic neuropathy be reversed?
doctor
Answered by Dr. Muhammad Hanif 4 hours later
Brief Answer:
We can prevent further spread to some extent by controlling diabetes!!!

Detailed Answer:
Welcome with this follow up query.

I have reviewed your query. MND usually affects all the voluntary skeletal muscles so is distributed as a widespread disease. I am more concerned about his diabetes mellitus that in the long run may cause Diabetic Neuropathy, if remains uncontrolled. It affects mostly the limbs and lower limb is its favorite prey to attack on.

You asked about the reversal of this neuropathy. Unfortunately not---we can't reverse the damaged nerve endings in peripheral nerves. In diabetic patients we usually recommend ACE-Inhibitors that have a protective role in diabetic neuropathy and kidney damage caused by longstanding high blood glucose levels.
We can delay the ill-effects of diabetes, or we can save a patient from further damages by controlling the disease.


Hope it helps. Please feel free to contact me anytime if you need further assistance. My direct link is: tinyurl.com/drhanifmd

Regards!
Dr. Hanif'
Above answer was peer-reviewed by : Dr. Deepak
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