A 70-year-old man with lower-extremity weakness and falls

A 70-year-old man with lowerextremity weakness and falls A 70-year-old man presented to the emergency department with lower-extremity weakness.He reported multiple falls over the previous 3 weeks.Four days before presentation, he had a fall that he attributed to weakness and pain in his right leg, resulting in injury to his right foot.He required a neighbor to help him up to a chair after that fall.Since that fall, however, his right foot felt "unstable" and he had resorted to crawling around his apartment to perform daily activities because of his foot pain.The ongoing pain prompted him to call emergency medical services, and he was brought to our emergency department.On presentation, the patient denied chest pain, shortness of breath, headaches, loss of consciousness, cough, blurry vision, nausea, or vomiting.His medical history included a 100-pack-year smoking history (1.5 packs per day), hypertension, paranoid schizophrenia, and emphysema (confi rmed previously on imaging).His current medications were amlodipine, aspirin, fl uphenazine injection every 2 weeks, doxepin, benztropine, gabapentin, umeclidinium, and vilanterol.