What to do after possible TIA

[tracy]

Last night my father was out to dinner & sitting at a hard wrought iron chair but hadn't been there more than 15 minutes.  He first stated that he felt his "center of gravity" was off.  After a couple of minutes he said that both his arms felt numb like his circulation had been cut off.  This seemed to get better very soon, probably within 5 minutes.  Then both his legs and feet got numb and his legs were left feeling weak for another 45 minutes.  We left right away & called his doctor as my dad didn't want to go immediately to the hospital.  His doctor called back & said he didn't know what the problem could have been.  My dad would like to think that sitting on this hard chair somehow cut off his circulation like when your foot falls asleep.  He didn't have any other symptoms and has had no other health issues.
  Could this have been a TIA and what would we do next?

[CCF Neuro[P] MD, RPS]

Dear Tracy:

It is difficult to say if this was a TIA.  The time period is in-line with a TIA.  However, the distribution is abit unusual.  TIAs usually encompass specific areas of the body, not the whole body.  We think of TIA usually occuring on one side of the body, or just a particular limb, or with nausea and vomiting with vertigo, loss of vision in one eye, etc.  Usually it does not involve a progressive whole body phenomena.  Certainly, this can happen but would be unusual.  I would contact your father's neurologist and get some testing performed.  Routine things like cholesterol, triglyceride levels, if family history of blood clots then a hypercoagulation panel, etc.  If your father has the risk factors for stroke, this would be another reason to get a neurological checkup.

Also, there are other reasons that could give the symptoms describe and their possibility should be investigated.

Sincerely,

CCF Neuro MD

[Bobbi D]

My dad was perfectly healthy last year when he had a similar "attack".  He went to the ER at a local hospital and although his BP was elevated, they couldn't find anything specific that caused the numbness.  They observed him for several hours and sent him home.  The next afternoon he started to walk into another room and stumbled - said his leg was numb.  Then his arm went numb.  Then his speech was slurred. Called an ambulance which brought him back to the ER - this time they did a catscan of his brain and found he had a massive stroke - which had started the day before when he complained of numbness. Because they didn't catch it the night before, it was too late to give him the proper medication (I think it's called TPA or something like that) that has to be given within a specific time period after the stroke.  He got progressively worse over the next week and passed away. Please take your dad to the doctor or hospital and have them do a catscan just in case. If it was nothing but the chair causing a problem, wonderful - if it was something else, maybe it is early enough to do something to save his life.  Good luck!

[Barbara]

Dear Tracy,

We just had a similar scare with my mother, so I wanted to share this with you, just in case it might help.  She had the same symptoms as your father; she also had slurred speech and extreme fatigue.  She was taken to the ER and it was eventually determined that this was not a stroke.  Her doseage of a diuretic/high blood pressure medication, Maxide, had been increased recently.  She was found to be extremely dehydrated and her blood pressure was dangerously low (she was going into shock).  When she was re-hydrated and her electrolytes were stabilized, her blood pressure did stabilize.  She did have a follow-up visit with her neurologist a day after her release from the hospital to confirm that her scans were clear of signs of stroke.  Take care and I hope your father is doing okay now.

[kd re: longstanding MR]

Hi!
I recently went through something similar.  In my case it was just my right side, upper body.  First my ring finger went numb followed by my thumb and other fingers, then my whole hand.  Then it started up my arm to my chest and back and neck.  At that point I got scared and called 911.  By the time the ambulance got here, I couldn't talk well.  All of this was reserved to the right side of the body.  The right side of my tongue wouldn't work.  The right side of my face and skull seemed numb.  My neurologist eventually admitted me for observation and tried heparin.  These episodes came back a number of times. They lasted from about a half hour to about 45 minutes.  My neuro came in and told me that he had recently seen several "weird TIAs" that turned out to be seizure activity (this type of progression is often seen in a Jacksonian seizure).  The EEG came back with seizure activity - a left temporal lobe seizure.  I went back to the hospital for a previously ordered MRI/MRA the next week.  Lo and behold, I had also had a stroke.  Most of the stroke was in the parietal lobe just next to where the seizure activity was. Since then, I have learned that many times stroke results in seizure activity.  Something I didn't know before.
  I have had 3 documented strokes and none of them followed the one part of the body, sudden onset pattern.  (No disrespect meant to the CCF Neurologist - this is just my experience.)  Perhaps the initial "stroke" is to one part of the brain and the increasing symptoms are due to the swelling/blood flow problems/etc.  I have read that most stroke damage isn't due to the initial insult but from the ripple effect.  I don't know.
  Would your father's doctor be willing to do an MRI/MRA?  (By the way, my first stroke doesn't show up on an MRI.  Only on a SPECT test.)

[heirja]

A related discussion, Waiting for Cat scan was started.

[mo58]

A related discussion, What can i do or not do now? was started.

[chamma]

A related discussion, Is it TIA was started.