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DrRussMd, Board Certified MD
Category: Neurology
Satisfied Customers: 65005
Experience:  Internal medicine doctor, diagnose and treat neurology patients, many years
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Ok... i'll bite... last evening i had a syncope event, which

Customer Question

ok... i'll bite... last evening i had a syncope event, which I have had before but with no clear diagnosis after lots of testing, holter monitor etc. Last night after a short period of blackout, maybe 5-10 seconds I was able to get up and go about my business out of the house. Within about two hours though, my legs became stiff and heavy. Got to be fairly difficult to walk and eventually I went to bed. Was able to sleep through the night without too much pain but legs remained stiff and very difficult to get up in middle of night. In am at 6, got up as usual for my two tabs of sinemet (my complete daily dose). Slept for another 90 minutes and when I arose, my legs were still both stiff and heavy but much better in terms of ability to walk. I am interested in knowing whether it more likely that I twisted or torqued by legs by falling or if it is more specifically a pd symtom. Any thoughts?
JA: What seems to make the symptoms worse or better? Any redness or swelling in the leg?
Customer: nothing has made the symptoms better or worse except possibly the sinemet made symptoms better. No redness or swelling in either leg. Feet also feel cramped which is not unusual.
JA: Anything else in your medical history you think the doctor should know?
Customer: not officially diagnosed with pd but believed probable by neurologist... began pd journey about a year ago... 67 year old white male...gout but no flares for quite a while.. left bundle branch thingie that I am told is not a problem
Submitted: 1 year ago.
Category: Neurology
Expert:  dr abid replied 1 year ago.

Hi there ...

Thank you for the question ...

This could be the part of TIA ( Transient ischemic attack ) .

I will suggest you to to have Carotid Doppler to rule out Carotid stenosis .

This will test us what to do next .

If Carotid Doppler is clear than CT Scan Brain is mandatory .

Regards ***** ***** luck .

Do you have any more questions?

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Expert:  DrRussMd replied 1 year ago.


That must have been quite concerning.

I am a double board certified US clinical doctor and will help you with your question.

To answer your question, this can be PD symptomology.

Please see this link

You say you have been extensively worked up.

It does not sound like a typical TIA. It is syncope which would be very rare from a mini stroke.

The heaviness in both legs is more like PD.

I suggest an exam now, and call your doctor.

You need a tilt table test. This rules out autonomic dysfunction.

That is common in this situation and often missed.

Make sure that you have also had an EEG to rule out seizures, as the bilateral leg heaviness would fit this more than a stroke.

I also suggest that it is not unwise to go to the ER at this point.

Simply because you have had this before is not a reason to delay an immediate evaluation, rather than scheduling tests later.

Although I think this is most likely ALL related to your PD, you should rule out acute events today.

The specific testing should be based on exam.

Again, in general terms, if not done: tilt table test and EEG. If there were any evidence of a TIA, they would certainly also investigate this.

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