TIA and effects?

[Shaztan]

Hi, I am 24 yrs of age and have been sick for the past 2 months. The first month, I had tiredness, right side headaches, weightloss and feverish feeling. Then, I had an episode that lasted about 3-4 hours where I had confusion, disorientation, tingling in right hand and right leg, slurred speech, difficulty understanding or answering questions, difficulty breathing and heavy limbs. Ever since, I have been having right hand, right shoulder and right chest pain. I have a paralyzed right vocal cord, weakness in my right arms, shoulder and leg. I also have pain in my right side neck sometimes. I also have severe shooting right sided head ache and I am not normally prone to headaches. These symptoms have altered my lifestyle since I get tired or bogged down with pain by the end of the morning. I initially had hot flashes when I'll feel hot and flushed. Now, for the past 4 nights, I have been waking up in the middle of the night drenched in sweat and I have to change my clothes before getting back into bed. I don't feel rested in the mornings and wake up tired. I have shortness of breath with exercise and sometimes tightness in neck and chest and find it difficult to take in air. I am NOT asthmatic. A PFT test revealed that I am unable to take deep breaths.
   I have been to and ENT and a neurologist. I did CT scan of chest, MRI of brains, soft tissue neck and cervical spine, blood tests for thyroid, mono, syphillis, wbc, cbc, lyme and a couple of other autoimmune diseases, EMG and EEG. All of them came out normal. My Vitamin D count is 19 and I have started taking 1000 iu of it.
   I am a 24 yr old female not under undue stress, I get 'brain fog' sometimes, just discovered the term but it describes how I feel. Also I weigh 101.5 lbs and am 5"2'. I used to weigh 109 lbs. My right eye is weaker than my left eye.

[Esteban Cheng-Ching, MD]

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 detailed history, I can not tell you what is the cause problems. I will provide some information that I hope will be useful.
A TIA is not common in a 24 year old person without a significant medical condition, so I am not sure exactly if you were told you had a TIA or not. Regarding your symptoms, you have some symptoms that sound very neurological, and others that could be associated and caused by neurologic problems or not. Regarding the right side symptoms and speech problems, some brain conditions affecting the left side of the brain can produce weakness, sensory symptoms and speech disturbance, however the distribution is not typical for something like a stroke, and the associated symptoms are not typical neither, also you say that your MRI was normal. Neck problems can also cause weakness and sensory findings, however they will not explain confusion or speech problems, and your spine MRI was not affected.
A vocal cord paralysis is an important finding that is not normal neither, and can be caused by problems affecting the recurrent laryngeal nerve, from lesions of the nerve itself, to problems throught its course. This may be also the sign of an underlying disease.
The fact that you have experienced fever, sweats, shortness of breath, and even mild weight loss, may suggest something more systemic, however I cannot say this with certainty. Systemic conditions includes infectious conditions like lyme or some viruses. Also inflammatory conditions or autoimmune conditions should be considered, and further autoimmune testing may be required depending on what was done. Sarcoidosis and vasculitis should be ruled out as well.
It seems that you have already had extensive testing without an answer.  
As I am not able to obtain a detailed history and exam, and I am unable to see your tests and imaging, it is very difficult for me to think about a specific diagnosis.
I think that getting a second opinion is very important at this time, as you have not been able to obtain a diagnosis or determine the cause of your symptoms. Seeing a neurologist for a second evaluation may be helpful. This may guide the work up in a different direction and consider other possible diagnosis that have not been entertained.
As I wrote, I am not sure about what the cause of your problems is, however I think you should seek a second opinion to help you determine what the cause of your symptoms is.
I hope this information is useful. Good luck.