Q. My dad has neck stiffness, severe headaches, leg weakness, and tingling hand. Please help.
Hi doctor,
Actually, my father has diabetes mellitus, hypertension, psoriasis, and psoriasis arthritis. For few days, he has neck stiffness, sudden severe headache. The pain usually starts from the back of the head or temple side. Pain starts anytime throughout the day. He complains of weakness in the leg, hand tingling, walking weakness. This suddenly occurs 2 or 3 times a day. Please help. He is taking Gabapin 100 mg, Betacap 20 mg, and Naxdom 250 when required. These three medicines are recently prescribed by the local medical doctor. I have the latest CT scan available.
Hello,
Welcome to icliniq.com.
The symptoms that you have mentioned about your father suggests brain infection or meningitis or encephalitis, or cerebral vascular accident (CVA), which means either bleeding from the vessels or blockage in the vessels.
The good thing is that the most lethal out of the above, which is bleeding in the brain, has been ruled out by the CT scan. The other things still need to be ruled out by some more evaluation.
- I would like to ask you a few more questions, like, does your father have any fever?
- How is his sensorium? Is he talking properly? Does he recognize everyone around? Is there a sudden change in his way of talking or responding?
- Is he able to control his urination and defaecation?
Based on all this, I will be able to narrow down my differential diagnosis, but you still need to visit a doctor in the hospital where they would examine your father completely and will be able to come to a diagnosis. Your father might need a lumbar puncture test in which a needle is inserted into the back to take a minute quantity of CSF which is the fluid that circulated around the brain, to come to a diagnosis, and for all these things, he would need to go to the hospital.
Also, an MRI scan may be required as a CT scan only picks up gross abnormalities, and some pathologies may be missed in the CT scan.
Investigations to be done:
MRI brain.
Lumbar puncture.
CBC (complete blood count).
Renal function tests.
Liver function tests.
CVA.
Meningitis.
Meningoencephalitis.
Migraine.
Meningitis.
Treatment plan:To be decided after the investigations.
Regarding follow up:Follow-up with the above reports.
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