Drop foot query

[VWPGSY]

Dear All

As some of you know, I lost my Dad to ALS four years ago in August 2014 and have struggled with both grief and health anxiety as a result.

The health anxiety was terrible after my Dad passed, and it manifested itself in lots of "twitching" which was diagnosed as BFS from stress/anxiety and having gone through all the tests etc, the anxiety subsided significantly in 2015 and diminished into the ether.

The last couple of weeks I have noticed my right foot feels weak and was "slapping" on the ground when I walked.

Its a big effort to lift my toes up off the ground (with heel on the ground), tapping my toes on the ground is slow and feels weak and I cannot put weight on my right heel and lift toes in the air (ie I can't walk on that heel).

My doctor has acknowledged the weakness and is referring me to a neurologist.

There is no sensory involvement, that is to say my leg feels "normal".

I am gobsmacked as to where on earth this has come from.

I can however squat, move ankle in circles and do calf raises/go on tip toes.

Am worried I have the start of drop foot, which I understand can be a precursor to ALS.

Any experience or insights gratefully appreciated. Thank you for your time.

 

[Bestfriends14]

I'm sorry for the loss of your dad to this dreadful disease, but I am just as sorry that now, many years later,you are still letting your health anxiety rule your life. That is terribly sad to hear. I am sure your dad would be even more sad.

In drop foot, the inability to do a heel to toe step manifests itself in tripping up stairs or when walking or running. When drop foot settles in, and only after quite sometime, does slap foot happen. By then, one is walking with such a pronounced limp that others are asking what is wrong, As well, needing to swing your hip with every step is a necessity so you do not trip over your dying foot.

So, from your description, you do not have drop foot nor do you fully understand all the parts that come into play in the onset of drop foot. That is actually a good thing. Please, address your health anxiety and do not let it rule your life further, It has all already taken away many years; It is up to you how many more years of your life you want to hand over to anxiety,

Best of luck to you.

 

[Nikki J]

Well it sounds like you have some kind of issue with the foot but there are many more causes of this than ALS that are far more likely. The neurologist will sort it out. Let us know what the answer is

 

[VWPGSY]

Thank you kindly for your replies.

What worries me the most is not being able to stand or walk on the right heel, and I recall when I had neurology tests back in 2015, walking on heels was something specific that the neurologist looked at, as I understood it to be a presenting symptom.

Back then I could walk across a room on both heels, now I can't take a single step on the right heel, hence the anxiety.

Accept there may be other reasons for the poor dorsiflexion but at this stage it is so hard to stay positive.

 

[Nikki J]

Yes the heel walking is a common test looking for weakness there. It is done in neurological exams, orthopedic exams, primary care exams and in other situations too. It is not specific to ALS and ALS is usually not even on the first page of a differential diagnosis

The most common cause is a local nerve injury and that may not hurt.

You can choose to think the worst of course but other scenarios are more likely. Again the neuro will figure it out. If s/he orders an emg / ncs ask what things they might see. The list is going to have other things besides ALS for sure including that nerve injury I mentioned

 

[VWPGSY]

Dear Nikki/All

I had an EMG today and I have "fibs+ No fasiculations. Mild excess of polyphasic units of normal or increased duration. Some rather large units recruiting early to mildly reduced interference pattern to 4mV".

He asked if I crossed my legs a lot and I said yes. He told me to stop, as it was the worst thing one could do for ones nerves.

The neurophysiologist has referred me back to the neurologist, but his report said "mild actice acute on chronic denervation of the right tibialis interior and conduction studies show a block at the fibular head level. A right common peroneal nerve lesion, focal to the knee, seems a very reasonable working diagnosis here. Remaining findings are normal"

Does this just mean I have a nerve lesion and nothing more?

The neurophysiologist was a nice man, but the test was done very quickly and he ushered me out before I could ask many questions.

Any comments or insights greatly appreciated.

 

[Bestfriends14]

No ALS! That's fantastic news so I do hope that you'll let this fear of ALS go once and for all. It's been many years of this fear and many years wasted and worrying about a disease you don't have.

Congrats that you no longer need to be here. Again, such good news. Any further questions can be directed to the doctor who you consulted with for better clarification.

Take good care.

 

[VWPGSY]

Sincere thanks to you and all other members that make this forum what it is. The support you have given me, and the support you give others is phenomenal.

I will take heed of your comment that I no longer need to be here and will duly stay away and move on with things, which include raising money for medical charities that support research into ALS, here in the UK it is the MNDA.

Thank you again.