[52M] Experiencing right-sided numbness and complex neurological symptoms

Patient Description

A 52-year-old male presents with a range of symptoms including a persistent headache that has worsened over the past week, described as a throbbing pressure behind the eyes and temples. The patient experiences sudden onset of right-sided numbness that feels like a 'shot of novacaine' with a sharp border, lasting about an hour. Additionally, there is occasional bowel incontinence without sensation, blurry vision, double vision, and a burning sensation in the right nostril concurrent with the numbness. The patient also reports stuttering, 'zoning out,' and dizziness, which has been worsening over the past three years, particularly when standing up and walking. The patient has a significant medical history including coronary artery disease (CAD), white matter disease, a 9 mm lesion in the left posterior frontal lobe, type 2 diabetes, hypertension, hyperlipidemia, hypothyroidism, arthritis, psoriasis, and eosinophilic esophagitis. The white matter disease and brain lesion were diagnosed a week ago, while the other conditions have been managed for the past 10 years. The patient has had a coronary artery bypass graft (CABG) and reports a family history of tachycardia, bypass surgery, and pacemaker implantation. No known drug allergies or substance use is reported. Current medications include metoprolol, lisinopril, atorvastatin, levothyroxine, omeprazole, and metformin.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are a few possibilities:

  • Transient Ischemic Attack (TIA) or Stroke: Your symptoms of sudden onset right-sided numbness, dizziness, and changes in speech could be signs of a TIA or stroke, especially given your history of coronary artery disease and other risk factors. A TIA is often called a "mini-stroke" and is a temporary blockage of blood flow to the brain. It can serve as a warning for a future stroke. A stroke is a more serious condition where the blood supply to a part of the brain is cut off, which can cause permanent damage.

    • Treatment usually involves medications to prevent blood clots and, in some cases, surgery.

  • Multiple Sclerosis (MS): This is a chronic disease that affects the central nervous system, especially the brain and spinal cord. It can cause symptoms like numbness or weakness on one side of the body, coordination and balance problems, and bowel incontinence. Your mention of a lesion in your brain and white matter disease could be related to MS.

    • Treatment often involves medications to control symptoms and slow the progression of the disease, physical therapy, and in some cases, surgery.

  • Migraine: Chronic headaches, especially if they are throbbing and located behind the eyes or temples, could be a sign of migraines. Migraines can sometimes be accompanied by other symptoms like dizziness and visual disturbances.

    • Treatment usually involves medications to relieve symptoms and prevent future attacks.

Please note that these are possibilities based on the information you've provided and should not be taken as a definitive diagnosis. It's important to consult with a healthcare provider who can evaluate your symptoms and medical history in person.

What you can do

Given the severity and sudden onset of your symptoms, it's important to seek immediate medical attention. If you haven't already, please go to the emergency department as soon as possible.

What you should look out for

If you experience any of the following symptoms, it's important to seek immediate medical attention:

  • Sudden severe headache
  • Trouble speaking or understanding speech
  • Sudden vision problems, such as blurriness or double vision
  • Sudden trouble walking or loss of balance
  • Sudden severe dizziness or loss of consciousness

Remember, I'm an AI and this advice is based on the information you've given me. It's always important to consult with a healthcare provider for accurate information.

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9 mo ago

People Also Ask

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

Symptoms of a TIA or stroke can include sudden numbness or weakness, especially on one side of the body, confusion, trouble speaking or understanding speech, vision problems, dizziness, and severe headache. Immediate medical attention is crucial.

How is Multiple Sclerosis (MS) diagnosed and treated?

Multiple Sclerosis is diagnosed through a combination of medical history, neurological exams, MRI scans, and sometimes spinal fluid analysis. Treatment focuses on managing symptoms, slowing disease progression, and includes medications, physical therapy, and lifestyle changes.

What are common triggers and treatments for migraines?

Common migraine triggers include stress, certain foods, hormonal changes, and lack of sleep. Treatments involve medications to relieve pain and prevent future attacks, lifestyle modifications, and avoiding known triggers.

What should I do if I experience sudden numbness or dizziness?

If you experience sudden numbness or dizziness, it's important to seek immediate medical attention, as these could be signs of a serious condition like a stroke. Visiting an emergency department is recommended.

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