Aa
Tia or IIH?
Hi. I hope you can help me. I am a 48yrs ,female, with IIH/PTC.I have a VP shunt fitted since Dec 08.Opening pressure done a month ago is still in the 30s and I have papillodeama in both eyes.
Last Fri I experienced an episode where i could nt speak properly. I was unable to pronounce words that began with M or C, slurred words and found it difficult to get the words out. Also using words and sentences back to front. I was fully aware at all times of what was going on. No other symptom, except headache.It lasted 3 hrs and 15 mins.It stopped as quickly as it had started.
On examination, by two drs, they both felt is was due to a rise and sift in the intracranial pressure.Blood pressure normal as was the Cat scan and bloods.At the hospital they concluded that it was a TIA.
I would very much appreciate your opinion and take on this.I am also a smoker and taking asprin and blood pressure tablets due to family history.( Mom had a heartattack at 70yrs ) Thanking you, Cath278
Last Fri I experienced an episode where i could nt speak properly. I was unable to pronounce words that began with M or C, slurred words and found it difficult to get the words out. Also using words and sentences back to front. I was fully aware at all times of what was going on. No other symptom, except headache.It lasted 3 hrs and 15 mins.It stopped as quickly as it had started.
On examination, by two drs, they both felt is was due to a rise and sift in the intracranial pressure.Blood pressure normal as was the Cat scan and bloods.At the hospital they concluded that it was a TIA.
I would very much appreciate your opinion and take on this.I am also a smoker and taking asprin and blood pressure tablets due to family history.( Mom had a heartattack at 70yrs ) Thanking you, Cath278
MEDICAL PROFESSIONAL
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 your doctor.
Without the ability to examine you and obtain a history, I can not tell you what the exact cause of your symptoms is. However I will try to provide you with some useful information.
With transient neurologic symptoms such as occurred in yourself, the usual possibilities include a TIA (which occurs due to transient reduction in blood flow to part of the brain), a seizure, or migraine. In your case, a transient increase in pressure is a possibility, though this may be less likely since your symptoms resolved spontaneously (making shunt malfunction less likely). It is sometimes very hard to distinguish seizures from migraine, but an appropriate work-up for both is necessary, with vascular imaging to check the blood vessels to the brain, a cardiac check-up, cholesterol check, and other tests, as well an EEG to check the brain wave activity of the brain and to look for signs of seizures. In some patients, after all these tests a definitive answer is not found, but if there are risk factors for TIA such as diabetes, high blood pressure, high cholesterol, smoking, or abnormal heart rhythm, treatment with a medication to thin the blood (such as aspirin or others), a cholesterol medication, and aggressive management of the risk factors is strongly indicated. If suspicion for seizures is high, treatment with a seizure medication may be indicated as well.
Continued follow-up with your neurologists is recommended.
Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
Without the ability to examine you and obtain a history, I can not tell you what the exact cause of your symptoms is. However I will try to provide you with some useful information.
With transient neurologic symptoms such as occurred in yourself, the usual possibilities include a TIA (which occurs due to transient reduction in blood flow to part of the brain), a seizure, or migraine. In your case, a transient increase in pressure is a possibility, though this may be less likely since your symptoms resolved spontaneously (making shunt malfunction less likely). It is sometimes very hard to distinguish seizures from migraine, but an appropriate work-up for both is necessary, with vascular imaging to check the blood vessels to the brain, a cardiac check-up, cholesterol check, and other tests, as well an EEG to check the brain wave activity of the brain and to look for signs of seizures. In some patients, after all these tests a definitive answer is not found, but if there are risk factors for TIA such as diabetes, high blood pressure, high cholesterol, smoking, or abnormal heart rhythm, treatment with a medication to thin the blood (such as aspirin or others), a cholesterol medication, and aggressive management of the risk factors is strongly indicated. If suspicion for seizures is high, treatment with a seizure medication may be indicated as well.
Continued follow-up with your neurologists is recommended.
Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
Dear Dr.Chahine,
Thank you very much for your answer.It did help me to understand a bit better what might be going on with me. I am seeing my neuro this Tues,which is good news.They ( the drs) are talking about putting a second VP shunt in soon.Hopefullly this will bring things closer to a finish and I can get back to a normal life! Again, thank you for your help and good advice.Cath278
Thank you very much for your answer.It did help me to understand a bit better what might be going on with me. I am seeing my neuro this Tues,which is good news.They ( the drs) are talking about putting a second VP shunt in soon.Hopefullly this will bring things closer to a finish and I can get back to a normal life! Again, thank you for your help and good advice.Cath278
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