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leg weakness
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leg weakness

I tore my achilles tendon in 2-06.  The first MD put me in aboot which did not help at all.  In May, 2006 I received surgery.  As it turns out the MD either severed or did not connect the sural nerve to the tendon.  I had surgery again in March, 2007.  I went to physical therapy and that leg has improved markedly.  About three months ago I felt a weakness in my "good" leg.  I started to drag my leg a little and have numbness in the front of my leg above the foot.  My reflexes in that leg are hyper.  My physical therapist said it is neurological.  I have an appointment with a neurologist, but not until January.  My shoe size has also gotten a full size smaller.  I work out several times a week, both cardio and strength training.  Could the good leg have been weakened by my overdependence on it for 13 months?  What could be wrong?
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Avatar n tn
Your problems seems to be of NOT Neurologic nature only.Overdependence could possibly cause muscle wasting .Have a close watch on your 'work-out 'programmes,do not over strain your muscles to the levels of becoming fatigue.If you lift too much of weight it can cause disc prolapse which in turn can lead to muscle weakness. Age related muscular weakness is another possibility.From Metabolic disorders and cardiac diesease to Hereditary causes, there are a gamut of reasons for leg weakness, Adrenoleukodystrophy is a condition which can cause leg weakness.A cardiac cause like Aortic Coarctation can cause leg weakness too ,conditions called 'Auto-Immune Thyroid dieseas' can lead to leg weakness too.Classic migraine can have symptoms of leg weakness.Please consult the general physician to rule out such causes in addition to a few other Metabolic disorders also.Blood related leg wekness like in Porphyria is to ruled out as well.
The following Lab tests would help in diagnosing the cause
Blood tests:
Full blood count, platelets, ESR, Electrolytes
Blood sugar to detect diabetes which can cause peripheral neuropathy, peripheral nerve lesions, increased risk of strokes
Thyroid function test (hyperthyroidism and hypothyroidism may have muscle weakness)
Lipid profile looking for high cholesterol can increase risk of strokes
Clotting screen if thrombotic stroke in young person or recurrent thrombotic disease to detect antithrombin III deficiency, protein C or S deficiency, lupus anticoagulant  -Clots can cause lowering of blood supply to muscle tissues and then cause pain.
Radiology investigations :
Lumbosacral spine X-ray
CT Scan or MRI of Lumbosacral spine - can detect nerve root entrapment in the intervertebral foramina of the lumbosacral spine or a disc prolapse.
Carotid artery Doppler - to measure flow through arteries to brain.
CT Scan Brain to detect stroke , brain mass
ECG - to detect atrial fibrillation that may have caused a stroke; can detect a recent heart attack that can predispose to a stroke.
Nerve Conduction studies:
Electromyography - to diagnose entrapment syndromes of peripheral nerve.
Apart from this other Hereditary reasons like Hereditary amyloidosis,Hereditary neuropathy and Hereditary spastic paraplegis should be ruled out.
Good luck.

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