Re: Headaches, Stroke-like symptoms, Short-term memory loss

Posted By Neil Richardson on October 08, 1998 at 23:36:07:

In Reply to: Re: Headaches, Stroke-like symptoms, Short-term memory loss posted by CCF Neuro[P] MD, RPS on October 08, 1998 at 12:51:47:






: : To Whom It May Concern:
My mother is unable to write this letter, so I am writing on her behalf.
: : Four weeks ago she suffered what our family and her doctors thought was a
: : stroke.  She woke up, and her speech was slurred, her right arm and hand
: : were numb, and later she had a terrible, terrible headache.  She was treated
: : for a TIA (mini-stroke) and was sent home.  After a few days, she began to
: : have awful headaches again, so much so she was not able to lift her head from
: : her hands and she was vomiting.  Back at the hospital they performed an MRI,
: : a CT Scan, and spinal-tap.  The MRI and CT were fine.  The spinal-tap showed an
: : elevated white blood cell count.  The doctors say that this indicated the presence
: : of a virus.  She was moved to a hospital in Pittsburgh where more tests were
: : done:  another spinal-tap, AIDS test, tests for cancer, brain wave tests,
: : all came back negative.  Over these two hospital stays, she had to more
: : stroke-like spells.  Now, she is in a rehabilitation center receiving physical and
: : occupational therapy.  She had another stroke-like spell there.  No one has
: : been able to figure out what the problem is.  Over the course of the past 4 weeks,
: : her short term memory has deteriorated somewhat.  She has good days and bad days.
: : Also, at times her speech is slurred, her walk is unsteady, her concentration level
: : is awful.  I would like to know if anyone out there has ever heard of anything
: : like this.  I am not a doctor,but  I tried to put down all of the history that
: : I know about my mother's case.  Please, if you have any information or
: : have ever heard of anything like this, we need to know.
Sincerely,
R. Goldsmith
Dear Renee Goldsmith:
I am sorry to hear about your mother.  As all the tests performed thus far are negative, most of the common things that might cause this have been thought about.  Combining all your symptoms, there are two catagories of diseases that may present like what you describe that may be happening to your mother.  One of the disease processes is a mitochondrial disease: MELAS.  This disorder is characterized by encephalopathy, elevated lactic acid levels, and stroke-like events (may also present as migraine).  There is a special DNA test that can be sent off to analayze the DNA for this disorder.  There are also other type of mitochondrial disorders that can initially give this type of presentation.  These would require special labs to be drawn and sent to certain labs across the country that specialize in mitochondrial disorders.  The second class of diseases that can present this way are the vasculitis type diseases.  One way of determining these type of diseases is to perform what is call angiography of the cerebral vessels.  We have seen both type of problems that initially present as your mother presented.  I hope that you can find an accurate diagnosis for your mother's problem.  Let us know.
Sincerely,
CCF Neuro[P] MD, RPS