Dr. Hitesh Kumar
Neurology
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Patient's Query
Hello doctor,
My mother has very high BP, and the doctor diagnosed her with TIA. She is unable to get up now. He had said that she will be fine in two or three days and will be able to get up on the bed. However, she fell rapidly on the bed again when we tried to lift her. We are giving her vertigo medicine 15 mg thrice daily. Can you please suggest something so that she can get up?
Hello,
Welcome to icliniq.com.
I would like to know some details about the symptoms:
Are these symptoms episodic or persistent throughout the day? What the patient exactly feel while trying to get up? Are there any weakness of arms, legs or facial deviation, change in voice, etc.? Is there any headache or vomitings? Does she feel any rotation of the surroundings or spinning of the head? If yes, while trying to get up, one episode lasts for how long duration? Is there any difficulty in hearing, ear discharge, or abnormal sounds in any ear?
There is only a prescription and ECG in your attachments (attachment removed to protect patient identity). No MRI (magnetic resonance imaging) is attached. Kindly send.
Investigations to be done
Regarding follow up
Patient's Query
Thank you doctor,
She is in bed for the past five days. Her head sometimes spins even when she opens her eyes. Most of the time, she is keeping her eyes closed. Today when she tried to get up. She fell the whole room spinning, and she fell immediately.
She has some cramps in the area below the chest and above the stomach. Her memory seems disoriented, and she is repeating the sentences sometimes. She has a slight headache and no vomiting. However, she has constipation and also is unable to sleep. Spinning persists for a long time, but the intensity is reduced. And this episode of getting up was not even for seconds. I had lifted her only about 15-20 degrees, and she fell again. So far, no abnormal sounds in the ear.
I am attaching the MRI report. It shows mild cerebral atrophy with inferior vermian agenesis and dilated cisterna magna communicating with the fourth ventricle. Dandy-Walker variant.
Hello,
Welcome back to icliniq.com.
I have seen the MRI report (attachment removed to protect patient identity).
Possibly she is having vertigo symptoms, which seems to be aggravated by positional change. MRI brain not showing any infarct or bleeding.
The finding of mild celebral atrophy with inferior vermian agenisis and dilated cisterna magna communaticating with fourth ventricle. This may be incidental findings of some congenital malformation of the brain.
Patient's Query
Thank you doctor,
When will her vertigo go? She is unable to get up at all. It is in the acute phase. Do we need to do other tests? Also, her BP increases with a spinning feeling. Do we need to give some additional medicine for that? Also, she is having sleep difficulties.
Hello,
Welcome back to icliniq.com.
It is difficult to predict the time frame for recovery. It varies from patient to patient. A few patients can have recurrence later, even after full recovery. I also suggest meeting an ENT specialist for an ear examination.
Acute vertigo can happen by numerous causes pertaining to the brain and inner ear pathologies. Inner ear pathology might not even be visualized on clinical examination. You still need to examine her ear for a few obvious causes.
For the addition of any medicine, it is better to go for a physical consultation.
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