desorientacion

Counting this, I had have about 5 episodies of:
lack of orientation
temporary memory lost
diziness
and i felt like my head is numb and also near the mouth area
Once it is gone i go back feeling normal and then it comes back again.
I really dont know why is this happening to me.  I have some herniated cervicals and in an MRI appears to have some little strokes (but doctors didnt worry about them) and lack of circulation in the brain area.
please help me getting a diagnostic and orientation I feel really bad.

[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.

Multiple episodes of memory loss, lack of orientation, dizziness, and numbness of the face/mouth all could be related to seizure, if the episodes are all typical. Other causes could include transient ischemic attacks, migraine, tumor, and multiple sclerosis to name a few. You say you have had a stroke before. I am not sure where the stroke is located and am not clear on the “lack of circulation in the brain area” that you mentioned, but I will talk a little about seizures following stroke given the broad differential.

It is uncommon for a seizure to occur at onset of a stroke but when it does, it can be a contraindication for stroke treatment (tPA). When a seizure occurs within the first week of a stroke, about half of these patients have another stroke within the next several years. Stroked areas of the brain can be an epileptic focus and recurrent seizures may occur in up to 15% of stroke patients.

Other causes of stroke-like symptoms, such as numbness of one side of face, include transient ischemic attacks, especially if the symptoms do not persist. You have had a stroke before and thus have stroke risk factors. Other risk factors include smoking, high cholesterol and blood pressure, and age.

The best approach to fully evaluate your symptoms is to be referred to a neurologist. He/she may want to obtain an updated MRI using a stroke protocol that includes DWI imaging. Also, an EEG would be needed to evaluate for epileptiform activity. The neurologist will decide on further workup.

If seizures are identified, you should be started on an anti-seizure medication. It is important to recognize that seizure medications do have risks such as problems with blood counts, interactions with other medications, drowsiness, dizziness, etc and this should be evaluated and discussed with your neurologist.

In conclusion, I would recommend that you follow up with a neurologist in your area.

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