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change in gait
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change in gait

52 y/o female with changes in walk/gait only on left side. Symptoms first noticed six months ago when trying to return to running after a couple of weeks of inactivity. I scuff the toe of my left shoe and stumble ( stopped running because of the stumbling). Walking  very far causes the ball of my foot just below my big toe and the outer side of my calf muscle to become sore. It seems more difficult to climb steps with the left leg. I also have had a tingling sensation in small spot in back of my knee and in my back about at the shoulder blade on the left side. My doctor did a strengh test and said I had weakness in the left foot with lifting big toe and lifting the outer side of my foot. Had EMG and NCV on legs, both appear OK. Doctor repeated strength test and said my leg seemed stronger.
I was involved in a vehicle accident but I walked away from the accident feeling I had no
significant injuries. The doctor thinks I have nerve damage to the left leg and thinks chthat it doesn’t show up on the tests because it is getting better.
I’ve noticed no improvement in walking.  Since the EMG & NCV didn’t indicate anything I’m not certain the cause of the symptoms is a nerve in my left knee or that it is even a result of the accident. I’m concerned my problems could be brain or disease related. Can you give me any help?

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Dear sandra905,

Thank you for submitting your question.
I will answer your concerns to the best of my abilities, but please be informed that I am unable to offer a diagnosis based on your history and list of symptoms.
I am extremely limited in not having the opportunity to perform a full neurologic examination on you.
This is solely for educational purposes and should in no way be a substitute for a formal evaluation by a certified physician.

From what I gather in reading your comment, you are having problems primarily on your left side -- specifically your foot, leg and shoulder area.

I am glad that you have undergone an EMG and NCS -- both of which are sensitive studies to look for nerve damage.

Honesty, based on your description of symptoms and your apparently unremarkable EMG/NCS, I am even questioning whether this is truly a neurologic problem, rather than a bone/joint problem.

Have you had imaging studies to look at the bones in the areas affected?
You could have very well impacted your musculoskeletal system during your car accident.

Brain damage from your car accident is very unlikely.
This is not the way that traumatic brain injury presents itself.
If you were to present to my clinic, I would consider a CT scan of the brain but probably not an MRI.

Either way, I would still recommend being seen my a neurologist, preferable a neuromuscular specialist.

You should definitely inquire about physical therapy as well with your primary care physician.
The last thing you want to do is decondition your muscles due to limited activity.

Hope this helps,
Best of luck,
JKL, MD

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