sudden loss "Use of legs"

F. Frank LeFever flefever at ix.netcom.com
Thu Jun 4 21:57:41 EST 1998

In <3576B045.25B at postoffice.idirect.com> K C Cheng
<kccheng at postoffice.idirect.com> writes: 
>Global wrote:
>> =
>> I hope that someone may be able to suggest a diagnosis for my
>> =
>> She is 82 years old, and for the last 18 monhs, has suffered
>> sudden loss of use in her legs.
>> =
>> She has no pain, and remains concious, however she collapses to the
>> ground, and has received various cuts and bruises.
>> =
>> I have noticed at times that she "Yawns" rather a lot, and also that
>> ankles swell ( Not huge) but larger than normal,and are very blue at
>> times.
>> =
>> She also at times has difficulty with her memory, and speech.
>> =
>> I first noticed something was wrong at my fathers funeral, when we
>> were leaving the crematorium, she was walking to the left, as if she
>> had no control.
>> =
>> She has seen her Doctor several times, who could find no explanation
>> and he referred her to a specialist, who also could not diagnose
>> anything.
>> =
>> I am getting very worried now, as she had a serious fall yesterday
>> the loss of use of her legs appears to be increasing.
>> =
>> I would be very obliged if somebody could give me an indication as
>> what could be wrong, so that I could suggest to her Doctor.
>> =
>> Thank you in anticipation
>> =
>> Peter Betts
>> GLOBAL at AGRICULTURAL.SSI.        btinternet.com
>> =
>> England
>Re above:
>This is an obvious case of non-fatal strokes.  Modern equipments such
>MRI can pinpoint where in her brain such damages have occured.
>-- =

NO, Kccheng, NOT "an obvious case of nonfatal strokes".  Read the
description carefully: Peter describes SPORADIC problems, raising the
possibility of transient ischemic attacks (TIAs), which may or may not
proceed to full strokes, i.e. with permanent damage which could perhaps
bne seen on MRI.  Read my prior response to this query in which I
describe some aspects of vertebro-basilar insufficiency, which
classically can include "drop attacks".

IF these are TIAs, and IF one catches them in progress (possibly with a
provocation) one might be able to see circulatory alterations with
Doppler.  re provocation: obviously one must be cautious (not wanting
brainstem infarct), but if there are known "naturalistic" conditions
which provoke these symptoms, they might allow identification of the
basis for them.  For ex: provoked by postural hypotension (standing
froom sitting position)?  Head turning? (with osteeoarthritic cervical
abnormalities, may sometimes compromise posterior circulation).

Conceivably, if chronically insufficient but short of actual stroke,
might be seen on SPECT?

F. Frank LeFever, Ph.D.
New York Neuropsychology Group

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