Unexplained Right Leg Weakness/Numbness while standing

[dave358]

Hello everyone,

My name is Dave and I am 23 years old.  I graduated from college in May and was accepted into veterinary school.  However, I have deferred admission for a year due to my walking difficulty.  I am 5’6”, 130 lbs and used to jog and do yoga before my walking difficulty.  I have an L5-S1 disk herniation from wrestling and soccer when I was 15.
My problem started in November of 2010.  I worked two nights a week at the dining commons in college and noticed a numbness and weakness in my right leg that got worse the longer I stood on it.  

The weakness would radiate from the foot through the hip.  Sitting would relieve the weakness.  I quit my job and tried to minimize walking over the next few months.  The weakness persisted and affected my gait.  I would increase my stride length while walking and rely more on my left leg for support.
I did not feel pain but rather a loss of functionality that worsened the longer I stood or walked.  I had X-rays of my hip and knee which were normal except for an abnormality in my hip socket that the doctor did not think was causing my problem.

I had a blood test done in March 2011 and found that I had Lyme disease.  I was treated with oral antibiotics for 2 months but did not improve my walking/standing (I had no other symptoms related to Lyme).  I was then treated with 1 month of intravenous antibiotics and still did not improve.  I had a spinal tap which didn’t show Lyme in the spinal fluid.  The Lyme specialist and a neurologist did not think the Lyme was causing my walking/standing difficulty but treated me for the Lyme anyway since it showed up in the blood test.  I also had a neurological exam which was normal.   The Lyme specialist suggested that I see a spine specialist because my weakness was positional and there was no evidence of nerve damage from the Lyme.

I also had an MRI (with contrast) of my whole spine and brain.  One neurologist said that the L5-S1 disc herniation was the cause and prescribed NSAIDs.  I tried two different NSAIDS for 6 weeks and saw little to no improvement.  I then saw a neurosurgeon and after that another neurologist who both did not think my L5-S1 disc herniation was the cause.  They said it was a small central herniation that extruded slightly to the left which did not explain my right leg problem.  A standing/flexion/extension lumbar MRI was also done and did not show stenosis or instability.  I also had an EMG/EEG which was inconclusive.

I have tried acupuncture and chiropractic adjustments without improvement.  The physical therapists at NIH also tried and could not determine the cause or how to fix it.  I also tried a steroidal foraminal spine injection on the right side of L5-S1 that has not helped.

The weakness/numbness has not improved.  It is vague and subtle but always gets worse the longer I stand or walk.  Usually it is difficult to stand or walk more than 2 to 3 minutes.  Sometimes my knees will hurt and feet (especially right foot) will slap after standing or walking even a couple minutes.  However, I can easily walk (even run) up and down the stairs, swim, and bike around my hilly neighborhood with no discomfort. Also, it is easier for me to walk with barefeet and on uneven surfaces (like grass hills).

Please let me know if you have any ideas about what this problem is.  My GP has suggested peroneal entrapment but hasn't seen a case like mine.

[beatonmr]

Hi Dave. I don’t have an answer but am very interested in your post. I sent you a message through this website and hope you might reply. I have had, and still have, similar symptoms for the past 4 months. Was interested to find out how you are doing now and if you ever got a diagnosis. I have had an MRI and am currently doing physical therapy, but it’s not helping.