Numb Legs and Constipation

Abstract

70-year-old man came to Neurology outpatient clinic with symptoms he had had for approximately 12 months. Symptoms were fluctuating. He reported “weird feeling” in both his legs. He described them as being numb as he “could not feel them properly and they were occasionally weaker”. He also had constipation and significantly delayed start of urination. There was previous history of sciatica 20 years ago. On objective examination reflexes were quite brisk in upper extremities. In lower extremities patellar reflex was increased on the left, normal on the right. Ankle reflexes were absent bilaterally. His right leg was weaker (4+/5) with normal strength (5/5) on the left. There was thermoception deficit on the right with normal pain and light touch perception. Proprioception was reduced on the right. On the left there was reduced pain, light touch and thermoception but proprioception seemed normal. Sensory functions in upper extremities and torso looked normal. Plantars were neutral/negative. There was urinary retention. Cranial nerves and cerebellar functions were normal.