[63F] Experiencing confusion, tingling, and difficulty swallowing

Patient Description

A 63-year-old female presents with symptoms that started approximately a week ago, including stuttering, tingling and numbness in the arms, difficulty swallowing, and confusion described as a 'foggy' head. The patient's confusion is exacerbated by stress and has led to a sudden decline in the ability to focus. The tingling sensation began as a general feeling that progressed to numbness, suggesting possible circulation issues. The patient's arms feel weak and heavy, particularly when lifted. An episode of low oxygen saturation was noted, dropping to 85 but improving with supplemental oxygen. The patient has a history of COPD, diagnosed 5 years ago, and is currently on medications including Placid, an Albuterol inhaler, Trelegy, and Zoloft. No allergies to medications have been reported. The patient has previously been to the emergency room for these symptoms but did not receive a definitive diagnosis.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, a few possible conditions could be causing your symptoms:

  • Transient Ischemic Attack (TIA) or Stroke: Your sudden onset of confusion, difficulty swallowing, stuttering, and arm weakness could be signs of a TIA or stroke. These conditions occur when blood flow to a part of your brain is blocked or reduced, often by a blood clot. The low oxygen levels you've experienced could also be related, as the brain needs a constant supply of oxygen to function properly.

    • Treatment for a TIA or stroke typically involves medications to prevent clots and reduce blood pressure and cholesterol levels. In some cases, surgery may be necessary.
  • Multiple Sclerosis (MS): This is a chronic disease that affects the central nervous system, which includes the brain and spinal cord. MS can cause a wide range of symptoms, including tingling or numbness in the limbs, difficulty swallowing, and confusion.

    • Treatment for MS often involves managing symptoms and slowing the progression of the disease with medications.
  • Chronic Obstructive Pulmonary Disease (COPD) Exacerbation: Your COPD could be worsening, leading to lower oxygen levels and causing some of your symptoms. Stress and other factors can trigger a COPD exacerbation.

    • Treatment typically involves medications to open the airways and improve lung function, as well as oxygen therapy in some cases.

What you can do

Given the sudden onset and severity of your symptoms, it's crucial that you seek immediate medical attention. If you're experiencing a TIA or stroke, prompt treatment can greatly improve your outcome. Even if your symptoms seem to improve, you should still see a doctor right away.

What you should look out for

If you experience any of the following symptoms, you should seek emergency medical attention:

  • Sudden numbness or weakness in the face, arm, or leg, especially on one side of the body
  • Sudden confusion, trouble speaking, or difficulty understanding speech
  • Sudden trouble seeing in one or both eyes
  • Sudden trouble walking, dizziness, loss of balance, or lack of coordination
  • Sudden severe headache with no known cause

Please remember that while I strive to provide accurate and helpful health information, I am not a doctor. You should always seek the advice of a healthcare professional for any health concerns.

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11 mo ago

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People Also Ask


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

Common symptoms of a TIA or stroke include sudden numbness or weakness in the face, arm, or leg, especially on one side of the body; sudden confusion, trouble speaking, or difficulty understanding speech; sudden trouble seeing in one or both eyes; sudden trouble walking, dizziness, loss of balance, or lack of coordination; and a sudden severe headache with no known cause.


How can Multiple Sclerosis (MS) affect the body, and what are its symptoms?

Multiple Sclerosis (MS) is a chronic disease that affects the central nervous system, leading to symptoms such as tingling or numbness in the limbs, difficulty swallowing, confusion, fatigue, and problems with coordination and balance. It can cause a wide range of symptoms depending on the areas of the central nervous system affected.


What are the signs of a COPD exacerbation, and how is it treated?

Signs of a COPD exacerbation include increased shortness of breath, wheezing, chest tightness, increased coughing, and changes in the color or amount of sputum. Treatment typically involves medications to open the airways, such as bronchodilators, corticosteroids to reduce inflammation, and oxygen therapy if needed.


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

Immediate medical attention for sudden neurological symptoms is crucial because conditions like TIA or stroke can lead to permanent brain damage or other serious complications if not treated promptly. Early intervention can significantly improve outcomes and reduce the risk of long-term disability.


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