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possible TIA?

Posted , 6 users are following.

angela1988
angela1988

My dad has had temporal arteritis for more than 10yrs now. He has been treated with prednisolone and latterly also methotrexate too. He has never been able to reduce to less than 12mg steroid daily.

On thursday morning he had an event that occured within 2hrs of being fine whereby my mum found hin collapsed and shaking, totally unresponsive verbally though not unconcious.

He was transferred to local hospital by emergency ambulance.

There he continued to be unresponsive to all stimulus, non verbal and vague.

He was also incontinent, pyrexial and chesty.

Immediate treatment with iv fluids and paracetamol then work up of bloods and ct brain are allegedly negative.

We are awaiting an urgent MRI now but two days on he has become gradually more alert and coherent but with tremor and headache. The headache was prevalent on becoming awake as he was post ictal following the event.

His only active treatment now has been with 30mg pred now and he states that the headache and tremor and weakness begin to recur as they wear off after approx 5-6hrs.

Docs on the ward today were going to discharge him but as he has not had the promised MRI or had definitive diagnosis we declined to take him home.

The only suggested diagnosis has been possible TIA?

They havent even asked his neurology team to be involved.

Do you out there think there is

Any other diagnosis to consider?

We are right to insist he is scanned before discharge?

Should see his neurologist?

Being too precious?

Should i be doing anything else?

0 likes, 26 replies

26 Replies

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  • misdiagnose
    misdiagnose angela1988

    Posted

    It sounds to me more than a TIA and should be under a CVA specialist. Did he never have a stroke assessment done in the past? Temporal Arteritis increases normal all the usual risks.
    • angela1988
      angela1988 misdiagnose

      Posted

      Latest update,

      Had Mri today and was informed that has had small stroke, been discharged home on aspirin 300mg for two weeks then to start clopidogrel.

      Mentioned his neurologist but was told he would get to know eventually!

      Steroids at 30mg to start reducing back to 15mg.

      Also on abx for chest infection and sputum been sent for further testing....unsure exactly what as yet? Pneumonia.

      Has been referred to TIA clinic and to expect an apt within 2weeks.

      Not sure if stroke is new or related to the Gca.

    • EileenH
      EileenH angela1988

      Posted

      Well gosh - there's a surprise. TGIM!!!! Keep an eye out for that appointment though - don't let the fast track slow to a crawl.

      Hope you are all feeling somewhat relieved at the conformation of what I'm sure you knew.

      All the best.

    • tina-uk_cwall
      tina-uk_cwall angela1988

      Posted

      Hello Angela, I know that not all your questions have been answered but at least he's had an Mri scan and he's had a care pathway of sorts established. GCA sufferers are at higher risk of strokes but as you say this stroke could be unrelated. I hope that each day his health improves and that it won't be long before he is back to his normal self. Be determined that he receives the best care because I'm afraid often it's the families that have to fight for it otherwise patients are simply fobbed off with second rate care. Regards christina 
  • angela1988
    angela1988

    Posted

    Thank you for your positive thoughts and suggestions.

    Today dad is recovering and obviously fatigued if not from the event but from admission.

    Dont worry I will def be chasing up his appointments. Will keep you posted.

  • angela1988
    angela1988

    Posted

    Well folks I thought I would give you the latest update.

    Dad went to the stroke clinic yesterday and the consultant said he has NOT had a stroke.

    Apparently the scans he had do not show any evidence of stroke and he has no indicators of stroke. He thinks he has epilepsy!!??

    Now has to see a neurologist and hes writing to his gp to send a referral FFS,! scuse my language but hes already got one!

    In the mean time stop aspirin dont start clopdogrel and the pred is at 15mg.

    • tina-uk_cwall
      tina-uk_cwall angela1988

      Posted

      Hi Angela, well, we really are at the mercy of clinicians! We go to them for reassurance and are lucky if we get a definitive diagnoses. With all the scans, tests and gizmos available, and diagnosis is sometimes a lottery!

      well, what else can I say other than to hope that your father is feeling much better and is well on the way to recovery. All the best, christina 

    • EileenH
      EileenH angela1988

      Posted

      TBH - that sounds far more in line with what happened and it just happened to happen at the same time as an infection. But what a performance to get that far...

      Why don't they listen and then think a bit? Looking forward to the next installment - I assume it shouldn't take too long to get an appointment with his existing neuro?

    • angela1988
      angela1988 EileenH

      Posted

      Thanks Eileen, I did say to the docs that were discharging him that it seemed a seizure event but wasnt taken up at that time!

      Apparently the stroke dr he saw on friday is writing to the gp to get hime to refer dad to a neurologist even though he has one already.

      Now i realise that even neuros have their own specialities but how much more delay will this process cause?

      Meanwhile hope no more seizures occur.

    • EileenH
      EileenH angela1988

      Posted

      The comment about incontinence suggested to me that seizure of some form should be up there...

      Is your father actively under a neuro? If so, a phone call would be enough I would have thought. If he has been discharged by the neuro that's a bit different. As for "their own specialities" - you get the neuro team where you are. Until there is a putative dx you can't say someone should go to this person or that one can you? It sounds as if they weren't listening - now why doesn't that surprise me?

    • angela1988
      angela1988 EileenH

      Posted

      I did at the time of admission suspect seizure rather than tia or stroke because of all the issues presenting, also because he was post-ictal for hours whereas tia only usually minutes and stroke can leave other signs etc...

      I have rung his own neuro 3 times since the event but was deferred each time by his secretary as on holiday/he will get a copy of the discharge letter/keep his apt on 9th April!

      Its like fencing...God help those who have no voice.

      Tomorrow he is trying to get a gp appointment so we shall see what the next chapter brings.

      Thanks for your support :-)

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