While conflicting rumours of Karimov's condition buzz through the Central Asian nation, one thing is sure -- the strategic country is facing a moment of uncertainty unparallelled in its post-Soviet history.
"The developments are unprecedented," Steve Swerdlow, Central Asia researcher for Human Rights Watch, told AFP.
"The entire state has been Islam Karimov, Islam Karimov has been the state for over quarter of a century ruling with an iron fist."
His younger daughter Lola Karimova-Tillyaeva announced on social media yesterday that he was in a "stable" condition in hospital after suffering a cerebral haemorrhage over the weekend.
Since then the authorities in the tightly-controlled state have released no further official statement on his health.
While there has been no confirmation of Karimov's latest condition and he could in theory stage a recovery, the gravity of his illness has left many in the country now facing up to the prospect of life without the only ruler they have ever known.
"There are two questions now: First, is there a plan for succession we don't know about? Second, even if there is, will the principals stick to it?" Radnitz said.
In theory the head of the senate should step in if Karimov dies or is incapable of ruling, but analysts dismissed him as a water-carrier.
Instead those tipped to take over more long term in the case of Karimov's long illness or death include Prime Minister Shavkat Mirziyoyev and Deputy Prime Minister Rustam Azimov, Kamoliddin Rabbimov, an independent Uzbek political analyst based in France, said.
Critics accuse Karimov of ruthlessly eviscerating all opposition in the cotton-rich country -- most prominently with the alleged massacre of hundreds of protesters in the city of Andijan in 2005.
But the veteran operator has managed to play Russia, the West and China off against each other to keep his regime from total isolation.
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