Clinical Case Database / Category: Case Based Discussion

Assessment of leg weakness in the older patient

Publication details

Dr. Sameer Limaye, Dr. Laura Dobson
Foundation Years Journal, volume 2, issue 6, p.256 (123Doc Education, London, July 2008)


You are assessing a 84–year-old gentleman who presented with a 3-month history of confusion and progressive weakness and paraesthesia in his lower legs. He has been treated with a course of antibiotics for a lower respiratory tract infection but he has continued to worsen despite this. He has a history of type 2 diabetes, ischaemic heart disease and hypertension. His medications are as follows:
- Aspirin 75mg od
- Bendroflumethiazide 2.5mg od
- Simvastatin 40mg od
- Ramipril 5mg od
- Amitryptilline 10mg od
- Multivitamins

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Dr. Sameer Limaye (Corresponding author)

The Stroke Association Clinical Fellow in Stroke
SpR Geriatric Medicine
Leeds Teaching Hospitals NHS Trust
Leeds General Infirmary
Great George Street

Dr. Laura Dobson

ST2 Core Medical Trainee
Leeds Teaching Hospitals NHS Trust


1. Levkoff, Cleary P, Liptzin B, Evans DA. Epidemiology of delirium: an overview of research issues and findings. International Psychgeriatric 1991 3:149–67.
2. The Royal College of Physicians National Guidelines Number 6. The prevention, diagnosis and management of delirium in older people. June 2006.
3. Ellyin FM, K umar Y, Somberg JC. Hypothyroidism complicated by angina pectoris: Therapeutic approaches. Journal of Clinical Pharmacology. 1992 32:843–47


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T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

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