Pain, Tingling, and Numbness in the Extremities With Foot Drop and Progressive Weakening of the Legs

Sumaira Nabi, MBBS; Rao Suhail, MBBS, FCPS Neurology; Shahzad Ahmed, MBBS


May 19, 2014


A 55-year-old Pakistani male presents to the emergency department with a 10-month history of numbness, tingling, and pain in both lower extremities and a 5-month history of similar symptoms in both arms. He also complains of having progressive, asymmetrical weakness in both legs, without sphincteric dysfunction, for two months.

There is no history of fever, cough, diarrhea, or constipation or of joint pains, weight loss, photosensitivity, polyuria, or polydipsia. The patient is an ex-driver by occupation who has eight children and belongs to a lower socioeconomic group. He is a nonsmoker and denies alcoholism.

He has had essential hypertension for five years and takes tablet bisoprolol 5 mg daily on a regular basis. Other than that, his medical history is insignificant. Family history is unremarkable.