My son limps on right feet

dear sir
           i hav a 2 1/2 old son who when walks takes his weight on inner part of his feet i.e. the part in line with thumb finger of the foot. this makes his ankle almost touch the ground. this make him loose balance and fall.  since last 8 months i observed he has been limping on his right leg. his MRI Brain was done few day back and it has the following observation

*  A focal area of altered signal intensity seen in the posterior limb of left internal capsule and adjacent area, measuring 10.4x8.6 mm in size and appearing hyperintense on T2WI & FLAIR and isointense on T1WI. it dose not show restriction on DWI sequence. it dose not show any blooming on gradient sequence. there is no post contrast enhancement seen. there is no midline shift or local mass effect seen.

*  There is prominence of the occipital horn of the left lateral ventricle as compared to the other side. the rest of the ventricular system , cisterns and sulcal spaces are normal.

* rest of the cerebral hemispheres reveal normal morphology and signal characteristics. no focal/diffuse region of abnormal signal intensity or enhancement is seen.

* the corpus callosum, basal ganglia, right internal capsule and thalamus reveal normal morphology and signal intensity.

*  the pituitary, Sella and para Sellar regions appear normal.

*  the posterior fossa structures reveal normal morphology and signal intensity.

*  the intracranial vascular flow voids and venous sinuses are normal.

* the visualised paranasal sinuses are normal.

[Shazia Alam, DO]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

Given the symptoms you have described and the MRI findings, I would be concerned whether your son may have had a small stroke in the past.  The area of the lesion is corresponding to this right extremities, which can explain why he is limping.  It could also be other things, such as inflammation, or tumor, however given the location, very atypical.  

I would recommend seeing a pediatric neurologist for an evaluation.  In addition, your son would benefit from physical therapy and possibly some type of brace so he doesn't hurt himself while walking.  It is however encouraging that he continues to move his right side, which hopefully will get stronger with therapy.

Hope this information was helpful.