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What Causes Inability To Move Legs After Partial Knee Replacement?
Question: I was recently hospitalized following a partial knee replacement. Shortly after surgery I was not able to move my legs, I have MS. The hospital neurologist was called in, I received 5 days of steroids , I started to move my toes, the doctor then added zanaflex and gabapentin, I was already on baclofen and topomax. After I was totally disoriented and weak the spasms were worst. A mri was ordered with T1 weighted images, of my cerv. sp and thor. sp they were fine. ( my lesions always show on T2 and flair). At the time of my release I was told it was conversion, 3 days after my release I saw my MS dr still disoriented they took me off the added meds and I improved. I am totally confused could it have been the medicines, and could the mri not show the problem because it was T1.
Brief Answer:
Yes, it was all due to the medications.
Detailed Answer:
Dr. Hanif warmly Welcomes you!
Thanks for consulting at my virtual clinic. I have carefully worked through your case, and can realize your health worries. Being your physician, I will take care all of your medical concerns.
Yes, it was all due to the medication you were taking. I will list all of your medicines and will briefly tell what are they used for:-
Zanaflex-A muscle relaxant.
Gabapentin-An anti-epileptic, anti-convulsant.
Topamax-An anti-convulsant.
Baclofen-A muscle relaxant and used to reduce muscle spasm pain and stiffness due to MS.
All of the above listed medications you were taking are almost similar in action, and due to the cumulative effects of almost all agonist drugs, you were feeling the symptoms. As your MS doctor took you off of medications, you felt improvements at large.
Have a wonderful time ahead. Hope I answered all of your questions. Let me know if you have any further clinical concerns. If satisfied, please give a five star rating and don't forget to close the discussion.
Regards!
DR. XXXXXXX HANIF
USA
Yes, it was all due to the medications.
Detailed Answer:
Dr. Hanif warmly Welcomes you!
Thanks for consulting at my virtual clinic. I have carefully worked through your case, and can realize your health worries. Being your physician, I will take care all of your medical concerns.
Yes, it was all due to the medication you were taking. I will list all of your medicines and will briefly tell what are they used for:-
Zanaflex-A muscle relaxant.
Gabapentin-An anti-epileptic, anti-convulsant.
Topamax-An anti-convulsant.
Baclofen-A muscle relaxant and used to reduce muscle spasm pain and stiffness due to MS.
All of the above listed medications you were taking are almost similar in action, and due to the cumulative effects of almost all agonist drugs, you were feeling the symptoms. As your MS doctor took you off of medications, you felt improvements at large.
Have a wonderful time ahead. Hope I answered all of your questions. Let me know if you have any further clinical concerns. If satisfied, please give a five star rating and don't forget to close the discussion.
Regards!
DR. XXXXXXX HANIF
USA
Above answer was peer-reviewed by :
Dr. Yogesh D
I am still confused as to why I was unable to move, before the medicine changes. My ms dr keeps telling me I had a possible relapse, but because the mri was done T-1 not T2 and flair and I was giving steroids immediately we may never know. I just don't want to take medicine for ms if I don't need too. The test by the hospital with T1 was normal and The ms dr has 5 previous reports that show lesions with T2 and flair.
Brief Answer:
You still need to take the medicines for MS.
Detailed Answer:
I welcome you back with a follow up query. I will explain what's confusing in this case.
Why your lesions always come up on T2 weighted FLAIR MRI?
It is the basic principle of MRI. T2 weighted MRI is programmed for visualizing the Lesions that have been popped there in the normal tissues. FLAIR technique is added when we suspect cerebral oedema and periventricular or cortical brain area lesions in conditions such as multiple sclerosis (as you have been).
They didn't went for your MS scanning. They wanted to know is the Normal Anatomy of your cervical and thoracic spine intact or there is some lesion causing the weakness and spasms in your muscles. TI weighted MRI is programmed to see the Normal Anatomy of the body. They didn't want to scan your brain and MS lesions actually in the hospital. They just wanted to make sure that your cervical and thoracic spine is looking normal or the cause of your aggravating symptoms are due to some changes in this region of spine.
Your T1 came out normal and they suspected that your worsening condition is due to flare up of MS (relapse). And now at this point even I will be unable to go and look back in the past to know what was going on in there, because they gave immediate Steroids which settled the relapse to some extent there and then. And also they didn't do T2 weighted MRI, otherwise we may see the relapse after comparing with your previous MRI reports.
In short, I want you to sit relaxed, and take MS medicines. Your MS doctor discontinued the added medicine because he didn't want to overdose you as they were all of almost same category they were used for, and I have explained that in detail in previous answer.
Have a nice time ahead. Hope there is nothing left unanswered from my side. If you have further questions, feel free to ask me anytime. If satisfied, please give a five star rating and don't forget to close the discussion.
Regards!
DR. XXXXXXX HANIF
USA
You still need to take the medicines for MS.
Detailed Answer:
I welcome you back with a follow up query. I will explain what's confusing in this case.
Why your lesions always come up on T2 weighted FLAIR MRI?
It is the basic principle of MRI. T2 weighted MRI is programmed for visualizing the Lesions that have been popped there in the normal tissues. FLAIR technique is added when we suspect cerebral oedema and periventricular or cortical brain area lesions in conditions such as multiple sclerosis (as you have been).
They didn't went for your MS scanning. They wanted to know is the Normal Anatomy of your cervical and thoracic spine intact or there is some lesion causing the weakness and spasms in your muscles. TI weighted MRI is programmed to see the Normal Anatomy of the body. They didn't want to scan your brain and MS lesions actually in the hospital. They just wanted to make sure that your cervical and thoracic spine is looking normal or the cause of your aggravating symptoms are due to some changes in this region of spine.
Your T1 came out normal and they suspected that your worsening condition is due to flare up of MS (relapse). And now at this point even I will be unable to go and look back in the past to know what was going on in there, because they gave immediate Steroids which settled the relapse to some extent there and then. And also they didn't do T2 weighted MRI, otherwise we may see the relapse after comparing with your previous MRI reports.
In short, I want you to sit relaxed, and take MS medicines. Your MS doctor discontinued the added medicine because he didn't want to overdose you as they were all of almost same category they were used for, and I have explained that in detail in previous answer.
Have a nice time ahead. Hope there is nothing left unanswered from my side. If you have further questions, feel free to ask me anytime. If satisfied, please give a five star rating and don't forget to close the discussion.
Regards!
DR. XXXXXXX HANIF
USA
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Answered by
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