Leg Weakness: Causes and When to Seek Help

Weakness in the legs?

Hello: For a long time, I have felt weakness in my lower legs while sleeping, making it difficult for me to fall asleep.
I have to rub my legs together until I get tired enough to sleep.
I have been accustomed to sleeping on my right side, but since last year, I have felt weakness in my entire right leg (starting from the thigh).
Previously, I only experienced weakness in both legs at night, but now my entire right leg feels weak even during the day.
I also feel slight weakness in my right hand (there have been occasional mild numbness episodes, but they occur only once every month or two).
This makes it even harder for me to sleep.
I now try to avoid sleeping on my right side as much as possible.
I take B vitamins and Ginkgo biloba daily.
What kind of condition might this be? If I go to the hospital, which department should I visit?

Ms. Tsai, 50~59 year old female. Ask Date: 2019/06/19

Dr. Cai Zongzhang reply Neurology

Hello, based on your symptoms, it is recommended that you visit the neurology outpatient clinic for nerve conduction studies and electromyography for further diagnosis.

Reply Date: 2019/06/19

More Info

Hello,
Thank you for reaching out with your concerns about leg weakness and the associated symptoms you are experiencing. Based on your description, it sounds like you are dealing with a complex issue that may involve several factors. Let’s break down your symptoms and discuss potential causes, as well as when you should seek medical help.

Understanding Your Symptoms
1. Leg Weakness: The sensation of weakness in your right leg, especially if it has progressed from nighttime to daytime, is concerning. This could indicate a neurological issue, muscular problem, or even vascular concerns. Weakness that is persistent and affects your daily activities should not be ignored.

2. Numbness and Tingling: The occasional episodes of numbness (or "麻" as you described) could suggest nerve involvement. This might be due to compression of nerves in the lower back (such as from a herniated disc), peripheral neuropathy, or even issues related to circulation.

3. Sleep Position: You mentioned that you have a habit of sleeping on your right side, which could potentially contribute to nerve compression, especially if your sleeping position puts pressure on certain areas of your body.
4. Associated Symptoms: The slight weakness in your right hand could indicate that the issue is not isolated to your leg. This could point to a more systemic problem, possibly involving the spine or central nervous system.

Potential Causes
- Nerve Compression: Conditions such as sciatica, which involves compression of the sciatic nerve, could lead to weakness and numbness in the leg. Similarly, cervical radiculopathy could explain the weakness in your hand if there is nerve root compression in the neck.

- Peripheral Neuropathy: This condition can result from various factors, including diabetes, vitamin deficiencies (like B12), or other systemic diseases. Given that you are taking B vitamins, it’s essential to ensure you are not deficient in other nutrients.

- Muscle Disorders: Conditions like myopathy can lead to muscle weakness. These disorders can be autoimmune or hereditary.

- Circulatory Issues: Vascular problems can also lead to weakness and numbness, especially if blood flow is compromised.

When to Seek Help
Given the complexity of your symptoms, it is advisable to seek medical attention. Here are some guidelines on when to see a doctor:
- Persistent Symptoms: If your leg weakness continues to worsen or does not improve with rest, it is crucial to consult a healthcare professional.

- Neurological Symptoms: If you experience any new symptoms such as severe headaches, vision changes, or loss of coordination, seek immediate medical attention.

- Impact on Daily Life: If your symptoms interfere with your ability to perform daily activities or affect your quality of life, it’s time to see a doctor.

Which Specialist to See
For your symptoms, you may want to start with a neurologist. They specialize in conditions affecting the nervous system and can conduct appropriate tests, such as nerve conduction studies or imaging (like MRI) to determine the underlying cause of your symptoms. If the neurologist suspects a vascular issue, they may refer you to a vascular specialist.

Conclusion
In summary, your symptoms of leg weakness, occasional numbness, and the impact on your sleep are concerning and warrant further investigation. It’s essential to consult a healthcare professional who can provide a thorough evaluation and appropriate diagnostic testing. Early intervention can lead to better outcomes, so don’t hesitate to seek help.

Take care, and I hope you find relief soon.

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