Suddenly can't move legs

[Whitfloor]

My friend had a general anaesthetic two days ago (her first) to correct a minor problem. She seemed fine. She's in her late thirties.

Two hours ago she felt very sick and became unable to stand. She became unresponsive. No raised temperature. An ambulance was called.

Waiting on a CT scan. She can't move her legs.

She was frightened about the possibility of having a reaction to the anaesthetic. Could this be a delayed reaction?

Reduced sensation in all four limbs. SATS fine throughout. Now perfectly clear mentally but passed out for a while in the ambulance.

What could be happening?

Causing leg weakness?!

Hope your friend feels better soon. she is in the right place. Hope the doctors find some answers.

How is she doing now ?.

Your friend, or someone advocating for her, must insist on seeing a neuro consult. FND is a convenient diagnosis, and for some, is not considered a diagnosis at all. GBS is a possibility, as are plenty of other things - time is of the essence to ensure no further damage or normality is not resumed. Do not accept it is psychological until everything else is investigated by a neuro team.

Anything with functional in the name is psychological. It means the patient is experiencing symptoms which have no known medical cause. Having positive symptoms doesn’t change that. It just means that, as with most psychological diagnoses, there a collection of symptoms which many patients share.

Medical professionals understanding of FND is surprisingly poor. There is an FND charity that can help.

My goodness op I didn't want to read and run, I hope your poor friend gets some answers and makes a swift recovery and I hope you have some support with you too

Why don’t you think it is psychological? Psychosomatic symptoms are much more common than some of the other diagnoses being suggested on here. It doesn’t make those symptoms any less real - they are absolutely experienced in a physical way.

I think people still feel there’s a shame or stigma attached to a psychological cause, which makes them resist it. People are much more willing to accept a diagnosis with a physical cause and think any suggestion of a psychological cause must mean their symptoms are being ignored or dismissed. That’s not the case at all and any diagnosis will be based on the symptoms and tests, whether a physical or psychological cause. One isn’t more valid than the other.

What a worrying time. I hope there's a diagnosis soon.

I remember a post ages ago that mentioned similar symptoms and Cauda Equina. Which can apparently be postoperative and needs urgent medical attention but other than I remember nothing about it, worth an ask?

Normal CT though. Im with psychological on this one…

Potential causes

1. Delayed Anesthetic Reaction:

- Uncommon but possible - Usually occur within 24 hours post-anesthesia - Typically not associated with such severe neurological symptoms

1. Acute Inflammatory Demyelinating Polyradiculoneuropathy (Guillain-Barré Syndrome):

- Can be triggered by surgery or anesthesia - Presents with ascending paralysis and sensory changes - Consistent with the described symptoms

1. Transverse Myelitis:

- Inflammation of the spinal cord - Can cause sudden onset of paralysis and sensory changes - May be triggered by immune system activation post-surgery

1. Conversion Disorder:

- Psychological stress manifesting as neurological symptoms - Pre-existing anxiety about anesthesia noted - Less likely given the severity and pattern of symptoms

1. Acute Disseminated Encephalomyelitis (ADEM):

- Rare inflammatory condition affecting the brain and spinal cord - Can occur post-surgery or infection - Consistent with rapid onset of neurological symptoms

Can you say more about the new research on fnd please? How new? And if it's recognised as having a physiological basis (presumably it is, if no longer seen as psychological), then is there anything specific known about this?

No, you’re stating with full authority What It Is when you don’t know.

Psychological is one suggestion on the table but there are many things that had to be ruled out first.

Also it wouldn’t exactly be the first time “it’s psychological” has been used incorrectly. I was told heavy periods and subsequent exhaustion was psychological until I measured my blood loss, took it to another GP who said “woah that’s not right”, sent me for tests and found that I have adenomyosis, bicornate uterus, and was severely anemic.

You sound like a lovely and very worried friend. I hope it's nothing too serious, our bodies can react oddily to illness, operations, immune reactions and stress. My DH had a sort of neurological reaction to extreme stress around a decade ago, it mimicked stroke symptoms, he went onto make a full recovery. Wishing your friend the best of health.

Obviously it’s not possible to diagnose anything but a young member of my family lost the use of their legs suddenly a year ago (no warning, no illnesses etc). They were diagnosed as having a functional neurological disorder. It was explained to me by one expert as a problem with your software rather than your hardware - basically, neurological messages your brain would usually send to your legs misfire and don’t hit the target. It’s a nervous system issue not a structural issue in other words. It seemed poorly diagnosed and understood (took us ages to get the diagnosis - the local DGH were clueless). Just something to consider if none of the tests your friend has prove another explanation. Some explain it as a psychosomatic issue - having done a lot of research I think that’s bullshit and a way of professionals inexperiences in the issue explaining away something when they can’t find a logical cause on a scan. It’s not about MH. Though there is an interplay between biological, psychological and environmental factors. Some information below.

btw my family member is recovering slowly with physio and has started to walk again. It’s been a long road and a battle to get appropriate physio etc.

www.sth.nhs.uk/services/a-z-of-services?id=115&page=293

Yes please link to this reported new evidence @pissedpocket ! I think you must have misinterpreted it somehow.

FND isn’t a really diagnosis it’s a label applied to neurological symptoms that don’t have positive test results - ie obvious signs of damage, inflammation, antibodies etc. The implication is that the cause is psychological, but personally it think it is simply that the nervous system is still poorly understood.

You’ll notice that few such patients get referred to psychiatrists which you’d think would be crucial if psychological problems were causing significant loss of function even paralysis.

It's scary how much stuff is posted on here with such confidence when it is nonsense.

I do suffer with anxiety but the past two times I was told by medical professionals that my physical symptoms were all down to anxiety that was not the case. This included being rushed back into surgery and having a blood transfusion.

Are women ‘more prone to anxiety’ because they are or because their real conditions are more prone to being labelled anxiety/hysteria?!

I hope ops friend makes a swift recovery.

This happened to my friend in her early 40s, it was GBS. Initially they said she was just being silly. So that's why I would fucking worry if my friend lost the use of her legs and was told its all in your mind dearie; that would very much seem to me to indicate she's NOT in the right place.

I hope you get better news soon OP, does she have family with her?

A suggestion - If the anesthesia contained nitrous oxide, it can wipe out your B12:

“Nerve damage occurs particularly often here, since B12 is responsible for the development of the protective layer over the nerves (myelin sheath). Typical symptoms that indicate the beginnings of nerve damage are numbness or tingling sensations in the limbs, which usually occur a few days after anesthesia when the myelin sheaths have been worn down.
Upon the occurrence of B12 deficiency symptoms after anesthesia, there is an urgent need for action to prevent permanent damage.”

https://www.b12-vitamin.com/anesthesia/

I have FND, diagnosed and treated by a leading neurologist in the field, and your statement is incorrect. Yes there are links/crossovers to psychology, you are more likely to have if if you have past trauma, and it is exacerbated by stress. But as PP stated, it is now understood that it is due to a software/signalling problem in the nervous system which does not show up on scans but is nevertheless real. You are clearly not a neurologist so please ease do not give out misinformation online.

https://advances.massgeneral.org/neuro/journal.aspx?id=1455

White matter link with FND. FND is a devastating disease, we describe it as the bastard love child of dementia, Parkinson’s and MS.

@Whitfloor i hope your friend gets a diagnosis soon.