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When Losing Weight Causes An Abnormal Gait - Page #1
 

Author: Aliza Saskin, MD
Co Author #1: Todd Shatynski, MD
Senior Editor: Christian Fulmer, DO, FAMSSM
Editor: James Robinson, MD, FAMSSM

Patient Presentation:
41 year old female with a past medical history of Diabetes Mellitus and obesity presented with 4 months of bilateral lower extremity numbness. She had no known inciting injury or trauma. Her symptoms began with difficulty walking and the sensation that her feet were slapping on the ground. She then started losing coordination of her lower extremities. Her symptoms were not associated with typical peripheral neuropathy pain.

History:
She was initially evaluated by her PCP. She was prescribed a muscle relaxer and 6-day steroid course, but her symptoms did not improve. She began some home strengthening exercises but did not enroll in formal physical therapy. She became unable to walk to the point where she needed a new closer parking space at work. The only other change to her health was a significant weight loss prior to onset of symptoms. She lost a total of 35 lbs. in 5-6 months on a GLP-1 agonist. Initially she was on Ozempic, lost 20-25 lbs. and then gained the weight back. She was switched to Mounjaro and lost 35 lbs. quickly.

Physical Exam:
Gen: Alert, well-appearing, pleasant patient in no acute distress
Bilateral lower extremities: Full range of motion at both hips and both knees. Mild antalgic gait, normal vascular function. Mild weakness with dorsiflexion equal bilaterally, 4 out of 5 strength. Knees show minimal patellofemoral tenderness. Negative valgus instability, Negative varus. Negative Lachman's, negative McMurray's. Mildly positive patellofemoral compression. Minimal effusion. Vascularly intact with no obvious signs of infection or trauma. Skin intact. Negative compressive Tinel's over the lateral knee at the fibular head bilaterally.

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NOTE: For more information, please contact the AMSSM, 4000 W. 114th Street, Suite 100, Leawood, KS 66211 (913) 327-1415.
 

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