Feeling Dizzy, Numbness In Leg And Weakness. Is It Due To Anxiety?

Posted on Wed, 5 Dec 2012

Question: Thanks for helping- I'm a 37yr female. For past month have had dizziness, intermittent waves of numbness in left leg, esp. Left arm, left hand tremor, waves of numbness left side of face/head and sometimes arching over to right side of head. Symptoms appear almost once a day now and can last a few hrs followed by a feeling of weakness in limbs. Noticing that this usually occurs now at night after being jolted awake to tend to crying baby. Medical info- possible bicuspid aortic valve, crazy fast epidural 8 mos ago. Two recent ER visits for symptoms showed clear blood work and clear CT scan. I've been told I'm an anxious person but I can't believe this is caused by anxiety. I'm taking no meds right now, just muti vitamin and a B complex.

Answered by Dr. Sudhir Kumar (12 minutes later)

Hi,

Thank you for writing in about your medical details. I appreciate the good description of your symptoms.

Based on your symptoms, the most likely possibility is transient ischaemic attacks (TIA). In this condition, the blood supply to a part of brain is reduced, resulting in neurological symptoms, which recovers within 24 hours, mostly within an hour. Since most of your symptoms are on the left side of body, it may signify a reduced blood flow to the right side of brain.

Seizure episodes can also cause similar symptoms, but they usually last only a few minutes. In your case, the duration is longer than that, hence, seizures are unlikely.

Further evaluation should include MRI and MR angiogram of brain, trans-esophageal echocardiogram, lipid profile, serum homocysteine, etc.

Also, I agree with you that anxiety is not the likely cause here.

I hope it helps. Please get back if you have any more queries.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, Hyderabad

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

Follow up: Dr. Sudhir Kumar (2 hours later)

Thank you immensely.
I just would like to add one more detail that I forgot - I do have auras without pain every day and was told in the ER that that may lead to stroke one day.
Given that I had extensive blood work done and a clear CT, I guess you are saying that maybe a TIA wouldn't show up on that?
I am currently waiting for a Dec 2 MRI of the brain (no contrast)..... is this good enough for diagnosing TIA?
I live in Canada and would like to speed up the process by going to the USA to pay for diagnostic testing immediately to rule out TIAs or tumors etc....
Would a basic MRI of the brain be adequate? I fear that if I have my basic Dec 2 MRI in Canada that it wouldn't be enough.....You also mentioned MRA - I guess that is more extensive? My 32 was diagnosed with an astrocytoma this year. I really just want everything covered. THANK YOU!!!

Answered by Dr. Sudhir Kumar (3 hours later)

Hi,

Thank you for getting back with more details.

Yes, CT scan is not enough for diagnosing TIA (however, astrocytoma or any other brain tumor more than 1 cm in size would show up on that, so, the chance of brain tumor is negligible).

MRI can help show ischaemic (areas of less blood flow) lesions in cases of TIA, however, in 50% of TIA cases, MRI could be normal. This is because the ischemia is for very short duration, which does not lead to any significant brain damage.

MR angiogram can be done in the same sitting as MRI, and requires about 5-10 minutes of extra scan time. It is non-invasive too and no XXXXXXX is injected. It helps to show any narrowing or occlusion of any brain blood vessel. So, you should get MRI and MRA done for complete evaluation.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)

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