ANXIETY OR TIA

I HEAR A LOT OF ANXIETY SUFFERERS LIKE ME COMPLAIN ABOUT TINGLING SENSATIONS ON HEAD, FACE. HOW CAN WE KNOW IF IT'S JUST ANOTHER HORRIFYING SYMPTOM OF ANXIETY AND NOT SOMETING MORE SERIOUS LIKE TIA'S?

[Christopher R Newey, DO]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

Anxiety is a psychological and physiological condition with a multitude of symptoms. They include heart palpitations, muscle tension, fatigue, nausea, chest pain, shortness of breath, headaches, and GI symptoms such as diarrhea to name a few. As you mentioned, the feeling of tingling can be another symptom. This sensation is usually migratory, i.e., moving from one place to another. Anxiety can also be accompanied with panic attacks such as a feeling of impending doom or death.

Transient ischemic attack (TIA) is a vascular condition in which a deficit occur transiently and leaves no permanent deficit and has normal neuroimaging. The symptoms and signs of TIAs are similar to those of stroke. For example, numbness or tingling or weakness of one side of the body, difficulty speaking, difficulty with grabbing objects (i.e., difficulty controlling where hand goes), vision changes or loss, asymmetry of smiling, etc are all presentations of stroke. Stroke is a neurological emergency. The treatment for stroke is time based. Thus, if a person has the symptoms of a stroke, they or someone else should call 9-1-1 ASAP.

Preventative stroke measures are also encouraged in patients who are at risk for stroke. These people are those who are older in age, smokers, have high cholesterol or blood pressure, vascular disease (coronary artery disease or peripheral vascular disease), prior stroke, family history of stroke, diabetes, etc.

It is difficult to say whether your symptoms are TIAs or anxiety based on the description you provide. Most likely they are anxiety related given the recurrence (but TIAs can be recurrent), and you do mention that you have a history of anxiety. I am assuming you have been evaluated for this. If you have not, I would recommend that you be evaluated for your anxiety by your PCP, but also for your stroke risk factors. If you ever have an episode of stroke signs and symptoms, you should be evaluated immediately at your local emergency department.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.