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MedHelp Member's Question

Between brain and foot

by staley, Feb 24, 2008 12:18PM
Occasionally while walking, the toes on my left foot will scuff the ground when coming forward. It's like my brain doesn't tell my foot to raise up when coming forward causing contact with the ground. Does this sound like beginning of parkinson's or ms or something?
Member Comments (18)

by Abhijeet Deshmukh, MD, Feb 24, 2008 12:48PM
To: staley
Hello.

If it is only the left foot that is problematic, you should consider some lower spine problem. A pinched nerve in the lower back can lead to weakness of the muscle that elevate the foot while walking.

Do you have any other symptoms ? Was there any back injury ?

Are you a diabetic ? Does your left foot have sensations ?

Regards

by staley, Feb 24, 2008 01:52PM
To: Abhijeet Deshmukh, MD
Thanks for the quick reply. I do have pain in the back, generally from the lower thoracic to the lumbar areas. I am able to walk on my toes and heels equally, but this exacerbates the pain in the back. My reflexes are normal including at the knee and ankle. Babinski reflex is normal. Occassionally, there will be a brief numb-like sensation in the left foot, but when I touch the foot I can feel the touch of a feather, pin, etc. Sometime, the sole of the left foot gets tingly. During my physical in the summer my fasting glucose was 104 mg/dL and AIC at 6%, which they said was okay, so I don't think I have diabetes. I do not recall a specific back injury. My coordination and motor skills seem fine. Interestingly, the arch on the left foot has somewhat collapsed over the past few months. Does this help any?

by Abhijeet Deshmukh, MD, Feb 24, 2008 08:22PM
To: staley
Hello.

Well, it seems you do not have symptoms due to a possible diabetic neuropathy. But there is certainly a neuropathy, which has caused to loss of arch.

Can you get Electromyography (EMG) and nerve conduction study (NCS) done ? These two will be helpful in finding out if you have some nerve problem.

Regards

by staley, Feb 25, 2008 05:17AM
To: Abhijeet Deshmukh, MD
Thank you for the information. On Friday, I was given a referral to a neurologist, but the appointment is not yet. Do you think it is more of a perpipheral nervous system disorder or a central nervous system disorder?

by staley, Feb 27, 2008 06:27PM
To: Abhijeet Deshmukh, MD
Well, I had the EMG/NCV today, which was normal. According to what I've read, some of the possibilites are stroke, diabetes, rheumatoid arthritis, parkinson's, ms, and hyperpronation. I have had recent blood tests for diabetes and stroke. If someone has a stroke, it's hard to miss right. I mean, I would know it, right. Any advice?

by Abhijeet Deshmukh, MD, Feb 27, 2008 07:53PM
To: staley
Hello.

I won't say stroke, but if you consider a transient ischemic attack, it still does not fit into the picture. A stroke will usually have other more distinct features associated.

Since the EMG has come back normal, a peripheral nerve disorder also does not seem to be the cause. Can you ask for a muscle biopsy ?

Regards

by staley, Mar 01, 2008 07:00PM
To: Abhijeet Deshmukh, MD
Hello again. I will ask for a muscle biopsy when I go back next week. Which muscle should it be performed on. The foot or calf or ankle area? Also, I have noticed that the condition really comes on when I have anxiety flare up. Thanks.

by caregiver222, Mar 01, 2008 07:47PM
Chances are you have what is commonly called "drop foor" and the cause is nerve compression secondary to disc deterioration in the lumbar region. You have textbook symptoms. I see no point in a muscle biopsy at this point, unless you are a masochist and enjoy pain and discomfor to pay for sins in a previous life. . What you need is an MRI , prefarably with dye contrast (not a CAT scan) and not an x-ray of the lumbar vertabrae. Often a protcedure called a laminectomy is considered. You need to get this done because if it goes on too long the condition may be permanant.

by staley, Mar 06, 2008 06:49PM
To: Abhijeet Deshmukh, MD
As I reported, my EMG/NCV is normal. A lumbar MRI has now been found to be normal. I just learned that some people have had sciatic nerve injury including drop foot after  receiving gluteal intramuscular injection. Well, I had a few injections (RIG) in my hips/back of my hips in August 2005. Could my symptoms be a sciatic nerve injury despite the normal test results? Note that my EMG/NCV is normal and I can walk on my toes and heels all around and across the room, but my left foot