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Muscle Weakness.

Resolved Question:

I have always had large leg muscles. Never was a fast runner. I have noticed trouble walking up steps in the last few years. I also catch myself tripping more often. I get around fine though with everything else. I no pain either, or nothing out of the ordinary. I was wondering if someone had thoughts on what it could be.


Category: Family Physician-GP

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Category: Sexually Transmitted Diseases(STD)Specialist
Dr. Deepu Sebin Sebastian is online now

Expert:  Dr. Deepu Sebin Sebastian replied 4 Days.

Hello,

Thank you for choosing DoctorSpring. I have discussed your consult with our team Neurologist . We will need some additional information from your so that we can provide our best and learned opinion. You can reply as a followup.

1. Do you have any trouble in passing urine ? (like hesitancy, dribbling etc)
2. Any back pain ?
3. Are you a smoker ?
4. Ever felt that you cannot grip your footwear properly ? (with your toes)
5. If you squat on the floor, are you able to stand upright without using your hands to support ?
6. Any symptoms in the upper limb ? as in trouble in raising the arm over head or trouble in lifting weight ?
7. Any loss of sensation ? numbness ?

You can reply as a followup
Thank you


Patient replied :

No trouble passing urine..I do have some lower back pain, but nothing super painful. I am not a smoker. No problems with my toes gripping foot wear or moving my toes. Squatting seams difficult without using my hands, but I can do it. No problems at all with my upper lims. No numbness or sensation feelings. I did have a blood test that showed muscle loss on my blood..I wasn't sure what that meant.


Expert:  Dr. Deepu Sebin Sebastian replied 3 Days.

Hello,

Thank you for your reply. You seem to have proximal myopathy of the leg. (weakness of thigh muscles). This could be due to number of reasons ranging from medication and Thyroid illness to neurological syndrome. You will need further tests to confirm the diagnosis. The test you have done is mostly CPK which was high. A complete blood count, Thyroid Liver and Renal function tests has to be done. You might also require an EMG test.

I understand that this can be frustrating but the diagnosis is a step by step process.
I will keep this consult open so that you can share the reports with me.

Hope this helps
Feel free to ask followups
Thank you


Patient replied :

Thanks for the info..I was tested for dystrophy as a kid because of my large calve muscles but they didn't think I had that..could this possibly be from that or an atrophy or is that common?


Expert:  Dr. Deepu Sebin Sebastian replied 2 Days.

Dystrophys is unlikely to present at this age. It could be a feature of other neuromuscular disease like polymyosistis, central core myopathies, acid maltase deficiency etc. It could occur in milder forms of many neurological disease. So as such the enlarged calf itself will not give a diagnosis, but it suggests a neurological disease which needs evaluation.

Hope this helps
Thank you


Dr. Deepu Sebin Sebastian
Category: Sexually Transmitted Diseases(STD)Specialist
Experience: 
MD, Internal Medicine - Stanley Medical School
Medical School - MBBS - Govt. Medical College, Kottyaam

Diagnostic Prediction - Stanford School of Medicine
Received Specialty training in Critical Care, Cardiology, Neurology, Gastroenterology, Nephrology from Stanley Medical College and in Endocrinology, Rheumatology.

Hematology and Geriatrics from Madras Medical College.
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