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Stroke

Was it a stroke 10-24?

11/07/2005

Question:

I am still confused so I will include symptoms and a CT report now also. She does have right sided weakness and is in a rehab to help strengthen everything. As for any facial effects there are none or at least any that have been noted. She was told she has fibromyalgia about 15-20 years ago since she has chronic pain all over that comes and goes and is in different places. She has numb places mostly on her lower extremidies. When she has a "flare" everything gets bad, including most symptoms that I have found for MS including eye disturbances. Sometimes she gets worse and other times a little better, but never back to the same place she was. When this recent event happened, she was no longer capable of standing, she went to the hospital where a lost of tests were ran, including the MRI results I have sent. No one is willing to explain how bad the stroke was and if it is the reason for what was shown on the MRI. Here is the CT: No intracranial hemorrahge is seen. There is an ill-defined area of low attenuation in the left frontal lobe, internal capsule anterior limb extending into the corona radiate consistent with a possible recent infraction. Conculusion: Evidence of left frontal infraction, indeterminate age. Recent infraction cannor be excluded. No hemorrhage seen. No mass or mass effect identified. So she had one, but was it little? She has had many mini strokes since the early 80`s and no, I don`t know how many, no one has ever said, only that she could have had one (during what ever time frame a new event was going on). I just "feel" that the fibromyalgia could have been misdiagnosed way back when, and it might really be MS, symptoms she has had since her early 30`s. Thanks for all help

Answer:

I think the problem is that your doctors are not sure, as the patient does not fall easily into a typical diagnosis. It seems possible that there was indeed a little stroke if the symptoms came on suddenly, but with the information you provided I cannot exclude another process going on at the same time or that a stroke did not occur. If MS is seriously considered, she should be seen by a neurologist who can perform tests such as a lumbar puncture that would be helpful diagnostically. I cannot offer any further opinion. I would urge you to see a neurologist and have them do a full history and physical examination, plus any testing that they think is indicated to get to the bottom of this. I would warn you that despite all of our knowledge and technology, we do not always have an answer for some cases, and I worry that this case may fall into that category. Best of luck.

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Response by:

Brett   Kissela, MD Brett Kissela, MD
Assistant Professor of Neurology
Director, Neurology Residency Program
College of Medicine
University of Cincinnati