Why does my mother show transient ischemic attack symptoms?

Question

Hi doctor,

My mother, aged 60, has been experiencing the following symptoms for around three months (please note that these were present before lockdown started and are not related to or developed in or due to lockdown). She feels as if her brain or her head is going to one side or is heavier on one side. This happens sometimes and is random. She feels like her head or brain has gone into transient paresthesia (sleeping sort). This also happens sometimes and is random.

Sometimes, when she gets to do some work, she suddenly feels that she cannot do it and sleeps with a slight headache. One day she got stunned for two to three seconds, and during this, she uttered junk or illogical words. I am concerned whether some clogging may have started (or such a scenario).

Her medical history has some problems (squeezing) with a heart valve, and she regularly takes medicines for it (for the last five years). She has less vitamin B12 absorption and has to take injections for it as required. Her present life is somewhat stressed (some family stress), and as a mother, she gets stressed. An MRI of the brain was done around seven months back (when there was a slight problem), and the doctor said it was completely fine.

Please advise if something is serious and what I can do.

Thanks and regards.

Answer 1

Hi,

Welcome to icliniq.com.

The initial symptoms you have mentioned are relatively nonspecific, except that she was stunned for a few seconds and uttered some specific words. That is a symptom that may suggest a transient episode of seizures or TIA (transient ischemic attack) or a reversible stroke-like effect, in simple terms.

If the MRI (magnetic resonance imaging) was done before that episode, it would be prudent to get a fresh one, as well as an MRI of the brain and neck angiography. I would like to know about the heart medicines she is taking.

If the MRI does not show a significant problem, then cardiac evaluation might also be required.

Was there any problem related to the right hand, like weakness or facial deviation on one side?
Does she have episodes of blackouts?

A neurophysician must properly evaluate and examine her thoroughly so that further evaluation can be planned. But these are the possibilities that I have mentioned. An additional recommendation would be possible only after taking a detailed history from her and a physical examination.

I hope this helps.

Thank you.

Answer 2

Hi,

Welcome back to icliniq.com.

Blackouts are like a sudden loss of vision or dizziness, and the black spots are different. Painful arm movement may be due to a right shoulder issue. Is there any weakness in the right arm as compared to the left side?

Not talking to anybody and abnormal sensations of smell may be psychological, but before stamping on that, we need to evaluate, as she had a doubtful episode of seizure as discussed earlier; it may be a part of it.

Valve issues can lead to clotting in the heart and may produce stroke-like symptoms, so I would like to see the echo report and preferably get a new one done concerning recent symptoms. So we will clarify upon receiving the latest reports.

I hope this helps.

Thank you.

Answer 3

Hi,

Welcome back to icliniq.com.

I have gone through the reports (attachments removed to protect the patient's identity), but these are pretty old reports, especially the echo scan. Were the blood thinners started for her?

If not, we should start it, but considering other symptoms that are not pointing towards specific disorders, it is difficult to prescribe a particular medicine. She would require a detailed evaluation.

To start with, I may suggest a 150 mg tablet of Aspirin once a day. The rest of the medication can only be advised after evaluation, as without proper diagnosis, it might be counterproductive to prescribe her medicines, especially considering the comorbidities.

I hope this helps.

Thank you.