Cause | Common Features* | Tests |
---|---|---|
Central nervous system† disorders | ||
Muscle stiffness Slow, shaky movements Loss of coordination and/or balance Incontinence or inability to urinate | A doctor's examination Sometimes MRI | |
Muscle stiffness Tremor Slow, shaky movements and a shuffling gait Difficulty walking | Only a doctor's examination | |
In people who are known to have had strokes | Only a doctor's examination | |
Spinal cord disorders | ||
Intense, stabbing pains in the legs that come and go Unsteady walking Decreased sensation in the legs and numbness or tingling | Blood tests and sometimes a spinal tap (to obtain cerebrospinal fluid) to check for syphilis | |
Tumors | Back pain Muscle weakness and decreased sensation in the legs | MRI |
Peripheral nerve† disorders | ||
Numbness, tingling, and weakness | Biopsy | |
Nerve damage caused by diabetes Diabetes Mellitus (DM) Diabetes mellitus is a disorder in which the body does not produce enough or respond normally to insulin, causing blood sugar (glucose) levels to be abnormally high. Symptoms of diabetes may... read more , excessive alcohol use, or nutritional deficiencies | Often burning pain and/or numbness in the feet and hands Sometimes weakness Usually in people who are known to have a disorder that can cause nerve damage | Nerve conduction testing and electromyography |
Sometimes decreased sweating and intolerance of heat Constipation or loss of control over bowel movements (fecal incontinence) Difficulty emptying the bladder | A doctor's examination Blood tests | |
A decreased volume of blood (hypovolemia) | ||
Thirst, decreased urination, and sometimes confusion | Only a doctor's examination | |
Excessive loss of blood | Often in people who have had an injury or surgery Blood in stool or black, tarry stool | A doctor's examination, including testing stool for blood A complete blood count |
An underactive adrenal gland | Weakness and fatigue | Blood tests |
Heart and blood vessel disorders | ||
Sometimes chest pain Palpitations (awareness of heart beats) Fatigue Shortness of breath Symptoms often occur suddenly | Event monitor | |
Chronic venous insufficiency Chronic Venous Insufficiency and Post-Thrombotic Syndrome Chronic venous insufficiency is damage to leg veins that prevents blood from flowing normally. Post-thrombotic syndrome is chronic venous insufficiency that results from a blood clot in the... read more (causing blood to pool in the legs) | Long-lasting swelling in one or both legs Chronic mild discomfort or aching in the ankles or legs but no pain Sometimes reddish brown, leathery areas on the skin and shallow sores, usually on the lower legs Often varicose veins | A doctor's examination |
Shortness of breath and fatigue | A doctor's examination Usually echocardiography (ultrasonography of the heart) | |
Heart attack Acute Coronary Syndromes (Heart Attack; Myocardial Infarction; Unstable Angina) Acute coronary syndromes result from a sudden blockage in a coronary artery. This blockage causes unstable angina or a heart attack (myocardial infarction), depending on the location and amount... read more (myocardial infarction) | Chest pain or pressure Shortness of breath or fatigue Sometimes in people who are known to have had a recent heart attack | ECG and blood tests to measure substances that indicate heart damage (cardiac markers) |
Heart valve disorder | Shortness of breath Often chest pain or pressure | Echocardiography |
High levels of the hormone aldosterone ( hyperaldosteronism) Hyperaldosteronism In hyperaldosteronism, overproduction of the hormone aldosterone leads to fluid retention and increased blood pressure, weakness, and, rarely, periods of paralysis. Hyperaldosteronism can be... read more or catecholamines (pheochromocytoma Pheochromocytoma A pheochromocytoma is a tumor that usually originates from the chromaffin cells of the adrenal glands, causing overproduction of catecholamines, powerful hormones that induce high blood pressure... read more ), usually caused by a tumor in the adrenal gland) | Weakness, tingling, muscle spasms, high blood pressure, and headache | Blood tests |
Drugs | ||
Drugs for high blood pressure or angina: Calcium channel blockers, clonidine, diuretics (such as furosemide), methyldopa, nitrates, prazosin, or rarely beta-blockers | In people known to use one of these drugs | A doctor's examination Sometimes stopping the drug to see if symptoms go away |
Drugs that affect the central nervous system: Antipsychotics (particularly phenothiazines), monoamine oxidase inhibitors, or tricyclic or tetracyclic antidepressants | In people known to use one of these drugs | Only a doctor's examination |
Sedatives: Alcohol or barbiturates | In people known to use one of these drugs | Only a doctor's examination |
Other drugs: Quinidine or vincristine | In people known to use one of these drugs | Only a doctor's examination |
Other problems | ||
Age-related changes in blood pressure regulation | In older people No other symptoms | Only a doctor's examination |
Bed rest if prolonged | In people who have been at bed rest for a long time | Only a doctor's examination |
A low level of potassium in the blood ( hypokalemia Hypokalemia (Low Level of Potassium in the Blood) In hypokalemia, the level of potassium in blood is too low. A low potassium level has many causes but usually results from vomiting, diarrhea, adrenal gland disorders, or use of diuretics. A... read more ) | Muscle weakness and cramping Pins-and-needles sensation Often in people who take certain diuretics | Blood tests |
* Features include symptoms and the results of the doctor's examination. Features mentioned are typical but not always present. | ||
† The central nervous system includes the brain and spinal cord. The peripheral nervous system includes the nerves outside the brain and spinal cord. | ||
CT = computed tomography; ECG = electrocardiography; MRI = magnetic resonance imaging. |