A combination of lower leg weakness and foot deformities is a
red flag for Charcot-Marie-Tooth disease (CMT) but isn’t
sufficient for diagnosis. When a patient has those symptoms, a
neurologist will usually start with a physical exam to look for
further signs of distal weakness and sensory loss. As a test for
leg weakness, a neurologist might ask patients to walk on their
heels or move part of their leg against an opposing force. To
look for sensory loss, the neurologist will usually test the
patient’s deep tendon reflexes (like the knee-jerk reflex),
which are reduced or absent in most people with CMT. During this
initial evaluation, the neurologist also will ask about the
patient’s family history. A family history of CMT-like symptoms,
combined with signs of nerve damage from the individual’s
physical exam, strongly point to CMT or another hereditary
neuropathy. Lack of a family history doesn’t rule out CMT, but
might prompt the neurologist to ask about diabetes, overexposure
to certain drugs and other pote