I am a podiatrist, with an interest in lower extremity neuro problems. In the past several months, I have seen several(5) patients with exactly your mothers symptoms. 3 of them had compression of the common peroneal nerve as it crosses the fibular head (outside of knee). They were also sedentary and had edema.
I would hope your original neuro did rule this out. I am still not sure why your original neuro did not do the emg? This I would think would completely at least rule in or out a radiculopathy or compression issue vs. "something higher up". The common peroneal nerve gets easily compressed when one with edema starts walking. The anterior leg muscles swell and tighten up on the nerve. The leg becomes very weak and the foot will drop. You can check for tenderness of this nerve when she is standing and look for a Hoffman tinels sign when the nerve is tapped. (tingling down leg or in top of foot).
good luck
First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes.
The symptoms you describe could suggest dystonic posturing of the left lower leg, that seems to be at least sometimes action induced. This could the early onset of a condition such as Cortical Basal Ganglionic Degeneration (CBGD), Parkinsons plus syndrome, or a primary dystonia. The SPECT scan is not usually the first step in the process of sorting this out, but the findings of your SPECT are suggestive of possible Cortical Basal Ganglionic Degeneration (CBGD). I would recommend getting an MRI/MRA of the brain, to evaluate for alternative causes, for example stroke, etc. Screening blood tests should include B12, RPR, TSH, Ceruloplasmin, ESR, CBC, electrolytes and copper/zinc. You may also consider formal neuro-psych testing, they have tests that specifically evaluate for frontal lobe dysfunction, that we would not recognize in everyday interactions. The typical approach to her dystonia would also include a trial on sinemet (levadopa/carbidopa). An EMG and lumbar puncture would also be reasonable tests if the above is not helpful. If you need to seek a second opinion to get the required tests to rule out other disorders besides CBGD, than do so, otherwise your neurologist will likely be willing to help. The prognosis of CBGD is not good, with a progressive loss of motor and cognitive skills over 3-6 years, with death usually occuring due to pneumonia or other secondary cause (Which is why we look for other more treatable diseases than CBGD). If you do seek a second opinion, I would see a neurologist that specializes in movement disorders.
I hope this has been helpful.
Hi
Though CBD (the new name for CGBD)is difficult to diagnose clinically and the known symptomes (the major or minor groups)are not very sensitive, but what you are describing is not any thing like regidity,apraxia, or what we could call alien limb were the foot would act on its own in a weird way.
These are the symptomes/sign of CBD
Major
Does your mom have any urinary incontinence or new memory problems? This could also be consistent with "normal pressure hydrocephalus" esp. given that imaging showed some prominent ventricles.