Bilateral Weakness of All Foot Movements

CLINICAL DIAGNOSTIC MANUAL

Bilateral weakness of all foot movements is a condition that may result from various neuromuscular and toxicological pathologies. This weakness affects the ability to perform voluntary movements of the foot, such as dorsiflexion, plantar flexion, inversion, and eversion.

Loss of strength in both feet can significantly impact gait and balance, increasing the risk of falls and injuries. Identifying the underlying cause is crucial to provide appropriate treatment and improve the patient’s quality of life. Possible causes include immunological disorders, toxic exposures, metabolic diseases, and hereditary neuropathies.

Condition	Clinical Symptoms and Signs	Suspected Diagnosis	Confirmatory Diagnosis
Guillain-Barré syndrome	Progressive ascending weakness, loss of deep tendon reflexes, paraesthesias, flaccid paralysis, autonomic dysfunction	Recent infection history, neurological exam, progressive weakness	EMG, nerve conduction studies, CSF analysis
Lead poisoning	Abdominal pain, anaemia, encephalopathy, peripheral neuropathy, muscle weakness, lead lines on gums	History of lead exposure, physical exam, systemic symptoms	Blood lead levels, urine analysis
Porphyria	Abdominal pain, peripheral neuropathy, muscle weakness, mental changes, photosensitivity	Clinical history, episodic symptoms, family history	Porphyrin analysis in blood, urine, and stool
Charcot-Marie-Tooth disease	Progressive distal muscle weakness and atrophy, foot deformities (high arches), sensory loss	Family history, neurological exam, characteristic deformities	EMG, nerve conduction studies, genetic testing