Suddenly can't move legs

Pleased to see this @Whitfloor I agree she should make sure this is followed up though

Ah I’m glad she’s feeling better @Whitfloor!

Yeah I think an anaesthetist knows what anaesthetics can do 😂 And that google search is entirely irrelevant in this case

I suspect you’ve wildly misinterpreted your search results.

Residual paralysis is only a problem if muscle relaxants were used and the anaesthetist was an idiot. It would not suddenly develop 2 days later and, as your quote suggests, it would be obvious on emergence and would be managed then. You don’t even know if the OP’s friend had muscle relaxants.

numbness from lying still might develop during an operation just like it would if you fell asleep in a daft position although padding and care with positioning minimises this as far as possible. It would typically affect a single nerve if it were to happen. Or if local anaesthetic had been used as part of the procedure clearly that could cause numbness/tingling however given that the operation was ear surgery it’s not relevant. An incision can cause nerve injury at the operative site. Clearly also not relevant here.

you can occasionally get some unusual movements as part of induction or emergence of GA. They happen during those brief periods then stop.

t couldn't find what I originally copied but this is from the NIH:

"... evidence suggests that undetected residual paralysis during emergence from anesthesia is common and may have deleterious clinical consequences."

"It may help to think of numbness and tingling as natural side effects of surgery. They can occur because of anesthesia, inability to move during the procedure, the surgical cut itself, or irritated nerves. In most cases, numbness lasts for only a day or two after surgery."

"Myoclonic movement is a rare side effect after general anesthesia."

However the op hasn't come back with an update so we still don't know what is happening with the patient. Hopefully she is now recovering.

Oh sorry, I misread your post. Apologies!

Yes I agree. I was replying to someone who said anxiety can't make you not feel your legs. At this stage I think it's supremely unhelpful for OP to be speculating, the doctors probably haven't even got all their test results back.

CT scan is the standard for patients presenting with stroke symptoms. Current treatment includes rapid anticoagulation if the stroke is cause by a clot visible using a contrast dye. Speed is of the essence since the anti coagulant needs to be administered within 4.5hrs of onset of the symptoms. As a result this rules out anyone with an haemorrhaging stroke and anyone whose stroke was not witnessed. Once the anticoagulant has been administered a further CT is carried out due to high risk of haemorrhage. The patient has to meet a strict set of criteria aswell resulting in only around 15% of stroke victims benefitting from anti coagulant therapy. There are other treatments.
So yes CT scans are used to identify strokes caused by clots because early intervention can be life changing.
My DH had a witnessed stroke, was in hospital in under an hour and diagnosed with a clot via CT in under 2hrs, then treated within the 4 hr window.
He was admitted at 6pm on a Friday and walked out of hospital unaided 3days later. On admission he couldn’t support his head or upper body and lost full function of his right limbs. The only visible sign that he has had a stroke is a slightly lobsided smile and he struggle with fine motor function in his right hand.

Without a CT they cannot differentiate between haemorrhages and ischaemic strokes so would be unable to use the anticoagulant therapy.
The CT scan is to quickly identify ischaemic strokes. No clot present does not necessarily mean it’s a stoke but if one is present they can proceed with what can only be described as a miracle treatment.

It’s also true that doctors don’t take holistic views or listen to patients a decent percentage of the time and that they make mistakes. I’m only alive right now because I ordered an MRI on a lump by mistake when I wanted one id had on my back for my chiropractor. When that came I found out that the cancer that was in my hip was ignored for an entire year. And would have continued to be ignored until I was dead presumably. As it is I lost a leg and might still die. So people are right to advocate for themselves.

Rubbish. (Doi: anaesthetist)

Is it not a reaction to the anaesthetic? Her symptoms fit that. Of course we can't diagnose on here but from what you say, op, it sounds like that. Reaction to some anaesthetic can manifest as paraesthesia, neuropathic pain (pins and needles), numbness and, rarely, jerking about. Having just written all that I think I already said it not long after you first posted so sorry if I did manage to post, am having problems with wifi going off and on.and my posts sometimes aren't 'sent' I'll try and find where I read it.

However it might have worn off by now. I do hope so.

It is dangerous to diagnose anxiety based on the few tests undertaken in A&E. Once the friend has received the full and appropriate specialist testing, then they can rule out a physiological cause.

Anxiety can cause a lot of psychological problems.

I just feel it's so close to the anaesthetic that something to do with that is more likely than a psychological reason as that is so rare and she has navigated poor mental health without that manifesting before

With respect OP, you're not a doctor. I get you're worried and upset but you have literally no idea.

... had I been able to type, I bet someone on here would have said "GBS" and I could have spoken uploud and clear. Advocated for myself.

Nobody is "armchair diagnosing", posters are suggesting things that have perhaps been misdiagnosed for them, friends or family. In order to help.

As for "GBS is 1:1,000000, yes. I was told that too. Since then, I personally found 5 people I know who had had family members that have had it.

My GBS was in the space of 2 hours.

It can be weeks or hours. I ended up in ICU unable to breathe.
I will never be the same as they did not diagnose me in time. My nerves are buggered.

https://www.seattletimes.com/nation-world/study-ct-scans-often-miss-strokes/#:~:text=The%20scans%20were%20independently%20interpreted,26%20percent%20of%20the%20time.

The most common method of diagnosing a stroke in emergency rooms catches only about one out of every four cases — far fewer than an MRI scan, which also was better at spotting the type of stroke, a U.S. government funded study showed...

...Chalela and colleagues examined 356 patients, of whom 217 were ultimately diagnosed with an acute stroke. Patients were scanned both by CT and MRI machines. CT scans are a type of X-ray, whereas magnetic resonance imaging uses powerful magnets instead of radiation to produce an image.

The scans were independently interpreted by four experts, who had no other patient information. Based only on the MRI scans, experts accurately diagnosed acute strokes 83 percent of the time. Using the CT scans, however, they were right just 26 percent of the time.

MRI scans were also more precise in spotting the cause of the stroke — a blood clot or bleeding in the brain. The vast majority of strokes are caused by clots. In patients scanned within three hours of symptoms, MRIs detected strokes caused by clots in 41 of 90 patients, while CT scans picked up only six of the 90 patients.

The first few hours after a stroke are critical, since clot-busting drugs must be given within three hours to have a real impact. If they are given to the wrong patients, however, death or severe disability can result.

--

Can posters please stop saying that a CT scan will "rule out a stroke".

Patients with ME and Long Covid are also sometimes incorrectly re-diagnosed with FND by neurologists.

For those who keep repeating that a CT scan will rule out a stroke:

CT scan won't always reliably rule out an ischaemic stroke (due to a blood clot).

Sometimes a stroke won't be visualised on a CT scan if it is carried out within a few hours of development of stroke symptoms. Whereas an MRI undertaken later will show the areas of damage and may also show evidence of historical damage from "silent" strokes which the patient had not been aware of at the time.

In our experience, patients referred to rapid assessment stroke units are often given a CT scan within a couple of hours after presentation and this is followed by an MRI several weeks later.

A CT scan may differentiate between an ischaemic stroke or a haemorrhagic stroke and guide rapid treatment.

NHS:

https://www.nhs.uk/conditions/stroke/diagnosis/#:~:text=If%20a%20stroke%20is%20suspected,to%20receive%20appropriate%20treatment%20sooner.

"If a stroke is suspected, a CT scan is usually able to show whether you have had an ischaemic stroke or a haemorrhagic stroke. It's generally quicker than an MRI scan and can mean you're able to receive appropriate treatment sooner."

I didn't say it was surprising or unexpected. Yes, it's no surprise the amygdala is involved. This could be useful information as part of diagnostic tests in the future, especially for those that may have had functional symptoms for extended periods of time without a diagnosis so far. Or it may be too complicated to ever get to the bottom of FND. Who knows! But like IBS, the more research and awareness there is the better.

I appreciate people's willingness to try and understand something that is really misunderstood. I myself may be completely wrong about how I understand my FND. And I agree, no one should armchair diagnose anything. I hope OPs friend gets the answer she needs.

In what way is it surprising/unexpected that there would be MRI changes in the amygdala given it's role in in mediating emotions? Could it not be a reflection of emotional distress?

although I wish people weren’t giving this lady an armchair diagnosis of FND it’s good to see how much more aware people are of it but equally how many misperceptions exist, for eg, it’s not a disease as someone has said. Western medicine is very good at dividing the brain from the body but it’s more helpful to see ourselves as a whole amazing system. We all have a “ fight, flight or freeze” response…a rabbit caught in a field has the option of running for its life or freezing in the hope the predator will pass by….the rabbit isn’t paralysed in this instance, its system has decided the best chance of survival is to freeze until danger has passed. As a physio if I went to see a person who was paralysed or had stroke symptoms, that person with FND would TRULY not be able to move the affected limbs if I asked them…but if I moved that limb or if I tried to stand that person ,their automatic functions might kick in and help,whereas with someone with a massive stroke or paralysis resulting from a spinal cord injury, that would not happen. The latter group, if you put them in bed would still be in the same position when the nurse comes to turn them; someone with FND may have changed position because their automatic responses have kicked in during sleep. We need to be incredibly carefully of presumptions when it comes to making diagnosis …as someone has said upthread ,many people get missed diagnoses of all sorts of conditions because a judgement is made on face value, and bias against certain groups ( women,ethnic minorities,the elderly etc) is very real!

I agree with your last paragraph. In general, there is still a stigma around mental health and psychological health disorders.

However, it is dangerous to rule of physiological causes of neurological symptoms based on the very basic tests in A&E. They have ruled out of the common, major life threatening causes of symptoms which is good news. They need to rule out other neurological causes too.

Sorry, my first sentence should say "that is how it should work"

That's not how it should work. Agreed.

But in my experience and that of many others that is unfortunately how it often does work.

I was quite happy to accept the symptoms were psychological when doctors insisted and I accepted put up with them for a long time. I am incredibly cross to now find they were entirely treatable. Likewise the people I know who ensured "IBS" for years only to find out they had coeliac.