[33F] With sudden loss of voice and facial droop

Patient Description

A 33-year-old female experienced a sudden loss of voice upon waking, with 0-1% voice function throughout the day. The patient reports difficulty moving lips and tongue, and a slight droop on the left side of the face. There is weakness in the left leg, but the left arm is unaffected. Previous episodes of voice loss have occurred, typically lasting 2-6 hours, with the last episode over a year ago. The patient has attempted various methods to regain voice, such as drinking, eating, and repositioning vocal cords, but these have not helped and sometimes lead to wheezing or coughing. Wheezing and difficulty breathing occur intermittently, accompanied by chest pain or tightness. There is no recent history of infections, illnesses, or travel, and no family history of stroke or neurological disorders. The patient also reports a recent sore neck. Medical history includes mild hypermobility, fibromyalgia, generalized anxiety disorder, undifferentiated connective tissue disease, and major depressive disorder. Allergies include Benadryl, Trazodone, and Tramadol. Current medications are Gabapentin, vilazodone, Claritin, Omeprazole, vitamin D, cognizin, zinc, vitamin B-12, and biotin.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, there are a few possibilities to consider:

  1. Stroke or Transient Ischemic Attack (TIA): The sudden onset of facial droop, weakness in your left leg, and difficulty speaking could indicate a stroke or TIA. These are serious medical conditions that require immediate attention. A stroke occurs when the blood supply to part of your brain is interrupted or reduced, preventing brain tissue from getting oxygen and nutrients. A TIA is similar but temporary and can be a warning sign of a future stroke.

  2. Bell's Palsy: This condition causes sudden weakness or paralysis on one side of the face due to inflammation of the facial nerve. It can also affect your ability to speak and move your lips. While not life-threatening, it requires medical evaluation to rule out other causes and to start treatment, which may include medications like corticosteroids.

  3. Vocal Cord Paralysis: This can result from nerve damage and lead to voice loss and difficulty speaking. It can be associated with other neurological symptoms and requires evaluation by a healthcare professional.

  4. Neurological Disorders: Other neurological conditions could cause similar symptoms, such as multiple sclerosis or myasthenia gravis. These conditions affect nerve and muscle function and require thorough evaluation and testing.

What you can do

  1. Seek Immediate Medical Attention: Given the severity and sudden onset of your symptoms, it's crucial to seek immediate medical care. Call 911 or have someone take you to the emergency room as soon as possible. Time is critical, especially if a stroke is suspected, as early treatment can prevent further complications.

  2. Monitor Symptoms: While waiting for medical help, keep track of any changes in your symptoms, such as worsening weakness, increased difficulty breathing, or changes in consciousness. Share this information with healthcare providers when you arrive at the hospital.

  3. Avoid Driving: Do not attempt to drive yourself to the hospital. If you are alone, call emergency services for assistance.

  4. Stay Calm: While it's natural to feel anxious, try to stay as calm as possible. Focus on taking slow, deep breaths to help manage any anxiety or difficulty breathing.

Remember, this advice is based on the information provided and is not a substitute for professional medical evaluation and treatment. Please prioritize getting to a healthcare facility for a thorough assessment.

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21 d ago

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People Also Ask


What are the common symptoms of a Transient Ischemic Attack (TIA)?

Common symptoms of a Transient Ischemic Attack (TIA) include sudden weakness or numbness on one side of the body, difficulty speaking or understanding speech, sudden vision changes, dizziness, and loss of balance or coordination. These symptoms are temporary but require immediate medical attention as they can be a warning sign of a future stroke.


How is Bell's Palsy different from a stroke?

Bell's Palsy is a condition that causes sudden weakness or paralysis on one side of the face due to inflammation of the facial nerve. Unlike a stroke, Bell's Palsy typically does not affect other parts of the body and is not caused by a disruption in blood flow to the brain. It is usually temporary and can be treated with medications like corticosteroids.


What causes vocal cord paralysis and how is it treated?

Vocal cord paralysis can be caused by nerve damage due to surgery, viral infections, neurological disorders, or trauma. Treatment may include voice therapy, surgery, or injections to improve voice function and breathing. A healthcare professional can provide a proper diagnosis and treatment plan.


What should I do if I experience sudden facial droop and weakness?

If you experience sudden facial droop and weakness, it is crucial to seek immediate medical attention as these could be signs of a stroke or other serious condition. Call emergency services or have someone take you to the hospital right away. Early treatment is essential to prevent further complications.


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