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40 yar old man who has TIA like symptoms at least 15 times ...

Sent to Health Experts October 02 05:39 PM

40 year old man who has TIA like symptoms at least 15 times in the past 6 weeks. They last from 10 mins to over 2 hours. Same sequence. Mouth numb, then left arm, then left leg. He becomes sweaty. Sometimes severe pain in left arm. Face droopy, slurred speech, then comes out completely. He's had angiogram, MRA, MRI, TEE, Cat Scans, Echos, ect. Any thoughts?

Edited by Customer (name blocked for privacy) on October 2 2005 at 11:04 PM

Customer (name blocked for privacy)
Status:  Closed   Value: $5
Answer
October 2 11:21 PM (5 hours and 41 minutes and 58 seconds later)
         
REPLIEDCheck Mark
These certainly sound like TIAs, and it appears he has had all of the appropriate tests to look for sources of strokes, including looking at the heart via echocardiogram. Have they looked at the carotid arteries, via carotid duplex or MRA of the neck vessels?

Other things to consider are a hypercoagulable state which can cause throbosis, vasculitis, and making sure these symptoms are not due to low blood surgars.

Referral to a neurologist is important to get to the cause of these episodes.

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M.D. - Neurological Surgery
Dr. Mark -- Doctor (MD) -- 100% Positive Feedback on 2070 Health Accepts
Physician/Surgeon in Neurosurgery, Maryland
Reply
October 2 11:26 PM (5 minutes and 6 seconds later)
         
Reply to Mark's Post: He's had 2 MRA's checking the carotid. He has seen 3 neurologists. Someone suggested Conversion but that would not explain the droop or the warning sign prior to the "episode". Any other thoughts?
Customer (name blocked for privacy)
Answer
October 2 11:39 PM (12 minutes and 34 seconds later)
         
ACCEPTEDCheck Mark
Considering it's always the left side affected, this suggests a structural cause for the TIAs, or something within the right sided circulation within the neck and brain.

Have they looked at the vertebral arteries as a possible source for the TIA's? There are two main sources of blood to the brain, the carotids and the vertebrals. I'm guessing they have if they did a complete 4 vessel angiogram.

If he really has indeed ruled out everything structural, as it seems he has, this is a very peculiar case indeed. The severe pain in the left arm doesn't quite match up with a TIA, as well as the sweaty episodes.

Please click "ACCEPT" if I answered your question to your satisfaction. A BONUS is appreciated. If you have other questions, please ask them.

M.D. - Neurological Surgery
Dr. Mark -- Doctor (MD) -- 100% Positive Feedback on 2070 Health Accepts
Physician/Surgeon in Neurosurgery, Maryland
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