Patient's Query
Hi doctor,
My wife has diabetes and hypertension. She suffered a CVA (left basal ganglia ICH) with right hemiparesis some months back. She is on Insulin (Novorapid and Lantus), Galvus Met 50 mg/500 mg (last 20 years), Telma 40 mg, Liofen, Statin 10 mg, and Felicita. Of late, she feels difficulty in walking. No strength in her lower extremity. She has pain in the legs.
I am her husband, and I am 72 years old. I have no medical history. We have three sons, and all are married. The eldest son is 50 years old. He is diabetic and hypertensive and has urine issues. The second son is 47 years old and has thyroid issues. The third son is 42 years old and has sinusitis. I am awaiting a reply.
Please help.
Thank you.
Hi,
Welcome to icliniq.com.
Please tell me a few details.
Please give the following required information,
Please revert with details for better understanding, and also, please send the previous reports along with prescriptions and discharge summary and, if possible, CT (computed tomography) images as an attachment.
I hope this helps.
Thank you.
Patient's Query
Hi doctor,
Thanks for the reply.
She feels pain while walking. Imbalance while standing and walking. She is always worried about her future due to diseases. There is no perceptible improvement since the stroke; rather, it has worsened. Pain and weakness (heaviness) is more in the right leg. Sugar level is under control (fasting 85 mg/dL to 110 mg/dL and after meal 150 mg/dL to 160 mg/dL).
Please help.
Thank you.
Hi,
Welcome back to icliniq.com.
Please ask these things from her and revert.
Thanks.
Patient's Query
Hi doctor,
Thanks for the reply.
She is getting physiotherapy.
Thank you.
Hi,
Welcome back to icliniq.com.
Please give information for all the points asked above. Is she getting physiotherapy or psychotherapy?
Thank you.
Patient's Query
Hi doctor,
Thanks for the reply.
She has shortness of breath. Her vocals are not audible. Her speech is feeble.
Please help.
Thank you.
Hi,
Welcome back to icliniq.com.
1. What kind of pain does she feel in her right leg? Is it stretching, tingling, pins and needles sensations, heaviness, current-like sensation, crawling sensations, burning, or something else?
2. Exactly in which portion of her right leg does she feel the pain? Hip, front or back thigh region, knee, calf region, ankle, or foot?
3. When did her pain in the legs start?
4. Does she have back pain also?
5. When did the weakness increase? How much could she lift her right leg in the air at the time of ICH (while lying straight in the bed ) and now?
6.Does she go to the restroom by herself, or does she needs the help of a stick or anyone?
5. How are her blood pressure recordings at home (now while taking regularly prescribed medicines)?
6. From when is she breathless?
7. Is it in a lying position or while walking?
Please ask these things from the patient and revert for each information point-wise.
I hope this helps.
Thank you.
Patient's Query
Hi doctor,
Thanks for the reply.
I have attached some reports for your reference.
Please help.
Thank you.
Hi,
Welcome back to icliniq.com.
I saw the pictures (attachments removed to protect the patient's identity). She is able to stand and walk with the help of a stick. But I have no clear description of her symptoms. I would like to know following information.
1. What kind of pain does she feel in her right leg? Is it stretching, tingling, pins and needles sensations, heaviness, current-like sensation, crawling sensations, burning, or something else?
2. Exactly in which portion of her right leg does she feel the pain? Hip, front or back thigh region, knee, calf region, ankle, or foot?
3. When did her pain in the legs start?
4. Does she have back pain also?
5. When did the weakness increase? How much could she lift her right leg in the air at the time of ICH (while lying straight in the bed ) and now?
6.Does she go to the restroom by herself, or does she needs the help of a stick or anyone?
5. How are her blood pressure recordings at home (now while taking regularly prescribed medicines)?
6. From when is she breathless? Is it in a lying position or while walking?
Please ask these things from the patient and revert for each information point-wise. You can also consult a neurologist.
I hope this helps.
Thank you.
Patient's Query
Hi doctor,
Thanks for the reply.
Can you please suggest some way to help her?
Thank you.
Hi,
Welcome back to icliniq.com.
Please give the information that I have asked previously for a better understanding. Moreover, in many situations, it is difficult to make a judgment with limited information.
Thanks.
Patient's Query
Hi doctor,
Thanks for the reply.
She has pain and heaviness while walking and getting up from the chair or bed. She has pain in the groin, the backside of the thigh, swelling, pain in her knee, calf, back. Her blood pressure is normal. She is taking Telma 40 mg. She has shortness of breath (not breathlessness while lying) due to short breath; she cannot read long sentences, this problem she has been having for the last five or six years.
Please help.
Thank you.
Hi,
Welcome back to icliniq.com.
As per your information, possibilities (differential diagnosis) may be,
1. Spasticity in her right leg (after stroke).
2. Deep vein thrombosis in her right leg.
3. Radicular pain in her right leg.
4. Diabetic neuropathy.
Following investigation might help make a conclusion,
1. USG (ultrasonography) venous doppler of bilateral lower limbs.
2. MRI (magnetic resonance imaging) of the lumbosacral spine with a full spine screening.
3. NCV (nerve conduction velocity) of bilateral lower limbs.
4. Serum vitamin B12 levels.
For the time being (till a conclusion is made), she can try the medicine, Tablet Gabapin 100 mg (Gabapentin) thrice daily for seven days.
Through limited sources, it is not feasible to come to one conclusion. In such a scenario, I suggest you consult a neurologist, who may also require investigations.
I hope this helps.
Thank you.
Was this conversation helpful?
Answered byDr. Hitesh Kumar
Medically reviewed byDr. Sneha Kannan
Same symptoms don't mean you have the same problem. Consult a doctor now!
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