Suggest Treatment For TIA And Muscle Weakness

Posted on Thu, 18 Jun 2015

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Thu, 18 Jun 2015 Answered on

Thu, 9 Jul 2015 Last reviewed on

Question : I have had a TIA recently and since then ( week) I have had transient events which aleways start with pain/pressure behind left eye and proceed to right side muscle weakness. The event (1 or 2 per day) last about 15-20 min. During my TIA realted hostipal stay, no blockages were found and the stree test very very good. They did find a reduced (below normal) LVEF. I don't understand what is going on.
I am scheduled to see a cardiologist next week.

Thank you

Answered by Dr. Ajay Panwar (15 minutes later)

Brief Answer:
MRI Brain with diffusion study.

Detailed Answer:
Hi XXXX,
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.

I would like to know a few things-
1)Were you examined by a neurologist for right sided muscle weakness during the event.If yes,what was his impression?
2)Did you undergo a MRI Brain?If not,you should undergo the one along with diffusion studies to rule out any ischemic injury to the brain.

Please follow-up with details so that I can answer your query in a better way.

Waiting for your follow-up.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ajay Panwar (7 minutes later)

Dr. Panwar:

I was examined by a neurologist after being admitted to the hospital but by that time the right side muscle weakness was prertty must gone and the exam was good.

I did undergo a MRI XXXXXXX and it showed no damage form the ischemic attack.

thank you.

Answered by Dr. Ajay Panwar (1 hour later)

Brief Answer:
Needs to be examined during the event/Treatment for TIA

Detailed Answer:
Hi XXXX,
Thanks for being in follow-up.

Even if MRI is normal,TIA remains the most probable diagnosis.It is must for you to get a neurological examination done during the event for the sake of diagnosis.History points towards TIA as the diagnosis.We can't go any closer towards the diagnosis here just on the basis of history.So,neurological examination during the event becomes necessary.

Empirically,antiplatelet(ecosprin) drugs and statins should be started,on regular basis.

Evaluation for all the risk factors of ischemic stroke should be done like Carotid Doppler,ECHO,ECG,Blood sugar(fasting and post prandial) or Lipid profile.

Hope that I have answered your query for now.If you have some follow up questions,I shall be glad to answer else please close the thread,rate it and write a review as your rating will be of help to me.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ajay Panwar (1 hour later)

Doctor: I want to make sure I understand. Are you thinking that the eye pressure and weakness over the last few days are recurring ischemic attacks happening after the larger TIA which landed me in the hospital?

thnak you

Answered by Dr. Ajay Panwar (7 hours later)

Brief Answer:
Recurrent TIA's

Detailed Answer:
Hi XXXX,
Thanks for being in follow-up.

Yes,the most probable cause here is Recurrent TIA's.Though,Hemiplegic migraine is another remote possiblility but there are some hard points against it(headache is preceding weakness,absence of aura symptoms like numbness,tingling,double vision).
But,as I said,it is a must for you to get a neurological examination done during the period of event.Possibly,a MRI Brain with diffusion,may need to be repeated.

Right now the next step-neurological examination during weakness.

Hope that I have answered your query.If you have some follow-up questions,I shall be glad to answer else please close the thread,rate it and write a review as your rating will be of help to me.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar