[47M] With facial numbness, headache, and dizziness

Patient Description

A 47-year-old male presents with sudden onset of facial numbness persisting for 2 weeks. The numbness is described as a sensation of pins and needles. The patient also reports associated symptoms of headaches, dizziness, and nausea, but denies any visual disturbances, weakness, or difficulty speaking. There is no history of recent infections, injuries, or changes in medications. The patient has a significant medical history including a previous NSTEMI myocardial infarction, kidney stones, irritable bowel syndrome, asthma, indigestion, and sciatica, all diagnosed over a year ago. Current medications include Brilinta (180 mg, twice daily), aspirin (once daily), Repatha (twice monthly), lisinopril (twice daily), metoprolol (once daily), and Jardiance (once daily). No known drug allergies.

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Arora's Assessment

What might be happening

Based on the information you’ve provided, there are a few serious conditions that could be causing your symptoms of sudden facial numbness, headache, dizziness, and nausea:

  1. Stroke or Transient Ischemic Attack (TIA): Given your history of a previous NSTEMI myocardial infarction and current symptoms, a stroke or TIA is a serious possibility. These conditions occur when blood flow to a part of the brain is interrupted, leading to neurological symptoms. Immediate medical attention is crucial to prevent permanent damage.

  2. Migraine with Aura: Migraines can sometimes present with neurological symptoms such as facial numbness, dizziness, and nausea. However, given your cardiovascular history, it is important to rule out more serious conditions first.

  3. Vestibular Disorders: Conditions affecting the inner ear, such as vestibular neuritis, can cause dizziness and nausea. However, the sudden onset of facial numbness makes this less likely compared to the other possibilities.

  4. Cardiovascular Issues: Given your history of heart problems, it is also possible that your symptoms could be related to another cardiovascular event.

What you can do

  1. Seek Immediate Medical Attention: Given the seriousness of your symptoms and your medical history, it is crucial that you seek immediate medical attention. Go to the nearest emergency room or call 911. Do not drive yourself; have someone else take you or call an ambulance.

  2. Monitor Symptoms: While waiting for medical help, monitor your symptoms closely. If you experience any worsening of symptoms, such as increased weakness, difficulty speaking, or severe headache, inform the medical personnel immediately.

  3. Stay Calm and Rest: Try to stay as calm as possible and rest while you wait for medical help. Avoid any strenuous activities.

  4. Inform Medical Personnel About Your History and Medications: Make sure to inform the medical personnel about your history of NSTEMI myocardial infarction, kidney stones, irritable bowel syndrome, asthma, indigestion, sciatica, and the medications you are currently taking.

Remember, I am not a doctor, and it is essential to seek care from real health professionals to receive a formal diagnosis and appropriate treatment. Your symptoms are serious and require immediate medical attention.

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3 mo ago

People Also Ask

What are the potential causes of sudden facial numbness?

Sudden facial numbness can be caused by several conditions, including stroke or transient ischemic attack (TIA), migraines with aura, or less commonly, vestibular disorders. It is important to consider the patient's medical history and associated symptoms to determine the cause.

How can a history of heart problems affect current neurological symptoms?

A history of heart problems, such as a previous NSTEMI myocardial infarction, can increase the risk of stroke or TIA, which can present with neurological symptoms like facial numbness. Cardiovascular issues can affect blood flow to the brain, leading to these symptoms.

What is the difference between a stroke and a transient ischemic attack (TIA)?

A stroke occurs when blood flow to a part of the brain is interrupted, causing brain cells to die, which can lead to permanent damage. A transient ischemic attack (TIA), often called a mini-stroke, is a temporary blockage of blood flow to the brain that does not cause permanent damage but is a warning sign of a potential future stroke.

Why is it important to seek immediate medical attention for these symptoms?

Immediate medical attention is crucial because symptoms like sudden facial numbness, headache, dizziness, and nausea could indicate a serious condition such as a stroke or TIA. Early intervention can prevent permanent damage and improve outcomes.

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