Questions about TIA

[Tkk81]

Im not too familiar with this site but would like to post my moms symptoms and hope for a dr. to respond.
My mom is 52 years old, she has had IDDM for about 8-10 years. Her sugars seem well controlled her bp is usually around 140-160 over 80-90. On tuesday night about 2300 she woke up feeling weak. She decided to stay in bed and wait, about two hours later she got up to go to the washroom and collapsed with paralysis in her legs, her speech was slurred. She immediatly called 9-1-1. Her sugar level at that time was 3.4. By the time she arrived at the ER, her symptoms had passed. The docs did an ECG and checked her troponin levels and all was well. They decided to send her home, I requested that they do a CT scan, but that showed nothing. They explained that it could be a TIA, but most likely due to low sugar. Then last night she had another episode, nothing nearly as severe, just some slight weakness on her right side, she was able to walk downstairs and smile in the mirror and all was ok, the symptoms passed shortly after. She is now on ASA. She has slightly high cholesterol(very slightly) and on Monday of this week she accidently doubled up on her insulin and had 80 units of 30/70 in the am. She was monitored that day closely. She also found a lump under her chin close to her carotid artery on the weekend. With all of this information, I am wondering if this seems she is having a problem with her sugars, TIA or a low flow TIA. It seems that this happens at night only and when she has been laying down for a longer period. We would like to prevent a stroke if possible, but unfortunarly due to her diabetes, the dr.s think thats all this is, but i am not so convinced. I would really appreciate some advise as to how to proceed or what you may think all of this may be. Is it a TIA??? Thank you so much

[Tkk81]

I thank you so much for the information you have provided. This has been so helpful. My mom will be going back to the doctor tomorrow and we will request some of the tests you have listed. She is hoping to get a carotid doppler done soon here. We do believe that the lump in her neck is causing this problem as this all started at the exact same time. And the lump is most likely caused by the crown in her mouth falling off along with a probable absess.

Thanks again,


Tanya

[JainMD]

Hi,
I think I have answered this post before but it is not reflecting here.
I recommend you to admit your mother and get her a Cerebral Angiography or Duplex carotid Ultrasonography.
Her symptoms sound as if there is obstruction in night due to swelling in her chin causing her carotid compromise.
Her symptoms such as monocular visual loss, hemiplegia, hemianesthesia, neglect, aphasia, visual field defects; less often headaches, seizures, amnesia, confusion are suggestive of carotid compromise.
I recommend her to be seen by another neurologist and observation in the hospital.
Keep me informed if you have any queries.
Bye.

[Sonaya]

Hi,
I am no medical expert and cannot offer any medical advice however I would be getting second opinions, referrals to a specialist.  More testing needs to be done, a neurologist for starters.
If she has a regular doctor she see's , get them to do a referral.
If you or your mum can write down everything that has happened and roughly the order in which they happend so you can be really really clear for the doctors.  Not only will it help the doctors but if this drags out a long time searching for answers, it will help to have something down.

The lump near the carotid artery you mentioned, doctors should refer your mum to have dopplar study ultrasound of the carotid artery.

If your not happy with whats been done, and it sounds like your not convinced, I would definately be getting more tests done and specialist attention for your mum.
Good luck.