What Are The Possibilities Am Losing The Ability To Walk ?

Posted on 24 hours ago

Question: Need a neurologist. Am losing the ability to walk without assistance. Issue has been progressing for 18 months. Many consultations. Causes eliminated. Not PAD, Spinal Stenosis, Arthritis, tumors on spine or nerves. Being treated for Light Chain Multiple Myeloma with Velcade and dextrusmethanesone. Started treatment 4/15/24. Not neuropathy per ONCOLOGIST. Not mechanical per PT and Ortho. Next stop, neurologist in 8 weeks. Walking is endurance not strength. PT fixed balance. Many kinds of pain. Skin hurts. Micro muscle spasms. Keeps me up at night. Have fallen 15 times over the 18 months. Tolerating Chemo well. What are the possibilities? AiC 5.1. Electrolytes balanced. Glucose 80.

Answered by Dr. Dr. Erion Spaho (39 hours later)

Brief Answer:
Autoimmune disorders to consider.

Detailed Answer:
Hi,

I have read your question about the progressive walking problem.

If spinal stenosis and neuropathy were excluded by tests (MRI for the stenosis and nerves conduction study for the neuropathy), I would consider autoimmune disorders such as transverse myelitis, multiple sclerosis, etc. as possible conditions that may cause such issues.

Imaging of the brain and spinal cord (MRI) and blood tests for the levels of the inflammation and antibodies are necessary to evaluate these disorders correctly.

Spinal tap and cerebrospinal fluid examination also may be necessary.

Discuss these issues with your Neurologist.

I hope you found the answer helpful.

Let me know if I can assist you further.
Thanks.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Dr. Erion Spaho (2 days later)

Thank you, very useful for my upcoming neurologist consult. One last question. Every Tuesday, as part of my chemo treatment, I take 20 MG of Dexamethasone along with the Velcade. None the rest of the week. For 30 hours or so, my leg pain goes away and I can walk without assistance and balance improves. No pain at night so I can get two night's sleep. When the cortisone begins to wear out, all of the symptoms return starting Thursday. We experimented for one week, skipped Velcade and took one 4MG a day. Less relief but some every day. So the reverse question is what is Dexamethasone addressing? What is it temporarily fixing? And does the answer redirect your differential ideas? Thanks

Answered by Dr. Dr. Erion Spaho (43 hours later)

Brief Answer:
I would explain as follows.

Detailed Answer:
Hello again and thanks for the follow-up questions.

I have read your question.

Dexamethasone is a steroidal anti-inflammatory drug that, in your case, relieves pain by lowering the inflammation of the nerves and vertebral column.

The inflammation of nerves may also be caused by autoimmune disorders, so, there is still need to consider and evaluate these conditions further.

I hope this helps.

Feel free to ask if you have further questions.

Take care.

Above answer was peer-reviewed by : Dr. Vaishalee Punj