Transient Left-Sided Paralysis: Causes and Concerns

Left-sided paralysis?

Hello, doctor.
When I was in elementary school, I experienced a brief episode of left-sided paralysis.
The paralysis would resolve on its own after a few minutes, and I also experienced numbness in the left side of my face and tongue.
I only remember three specific instances: one occurred during a flag-raising ceremony on the playground, another happened while I was undergoing an EEG, and the last one occurred after I drank hot soup and blew on it.
I had an examination at Kaohsiung Medical University, but nothing was found.
My family mentioned that I fell from a height of about one to two meters in kindergarten and hit my head, but there were no signs of brain injury at that time.
However, the paralysis symptoms stopped after sixth grade.
Whenever I had a headache, it was severe and accompanied by vomiting, to the point where I would vomit bile when my stomach was empty.
This was almost always the case.
Fortunately, during high school, these symptoms lessened, and I rarely experienced headaches.
However, in the past year or two, it seems that the symptoms have recurred, with frequent headaches and dizziness.
The more severe the situation, the weaker my left limbs feel.
In 2003, I accidentally spilled hot soup on my left hand, which caused increasing dizziness and weakness on my left side, ultimately leading me to collapse.
Recently, my headaches and dizziness have worsened, occurring almost daily.
What could be the cause of this?

Xiao M, 20~29 year old female. Ask Date: 2005/03/08

Dr. Lai Lunxiang reply Neurology

Hello, I believe you have 1.
tension-type headache and 2.
anxiety disorder.
Please visit the hospital's psychiatry or neurology department for consultation.
Thank you!

Reply Date: 2005/03/08

More Info

Transient left-sided paralysis, especially when accompanied by facial and tongue numbness, can be concerning and may indicate underlying neurological issues. The symptoms you've described, including episodes of paralysis that resolve within minutes, suggest a possible transient ischemic attack (TIA) or other neurological events. Here’s a detailed exploration of potential causes and considerations regarding your condition.

Possible Causes of Transient Left-Sided Paralysis
1. Transient Ischemic Attack (TIA): TIAs are often referred to as "mini-strokes." They occur when there is a temporary decrease in blood flow to a part of the brain, leading to symptoms similar to those of a stroke, including weakness or paralysis on one side of the body. The symptoms typically resolve within 24 hours, often within minutes, which aligns with your experience. TIAs are significant warning signs for potential future strokes.

2. Migraine with Aura: Some individuals experience migraines that can cause neurological symptoms, including temporary paralysis or weakness on one side of the body. This is known as hemiplegic migraine. The fact that you have a history of severe headaches accompanied by nausea and vomiting could suggest this type of migraine.

3. Seizures: Certain types of seizures, particularly focal seizures, can lead to temporary paralysis or weakness in specific body parts. Postictal paralysis (Todd's paralysis) can occur after a seizure, where the affected side may remain weak for a period following the event.

4. Cervical Spine Issues: Problems in the cervical spine, such as herniated discs or spinal stenosis, can lead to nerve compression that might result in transient weakness or numbness in the arms or legs.

5. Vascular Issues: Conditions affecting blood vessels, such as arteriovenous malformations (AVMs) or other vascular malformations in the brain, could lead to transient neurological symptoms.

6. Head Trauma: Given your history of falling and hitting your head, it’s possible that there may have been some underlying injury or structural change in the brain that could contribute to your symptoms.

Concerns and Recommendations
Given your history of transient paralysis, severe headaches, and recent episodes of dizziness and weakness, it is crucial to seek a comprehensive neurological evaluation. Here are some steps you should consider:
- Neurological Assessment: A thorough examination by a neurologist is essential. They may recommend imaging studies such as an MRI or CT scan to evaluate for any structural abnormalities, vascular issues, or signs of past strokes.

- Monitoring Symptoms: Keep a detailed log of your symptoms, including the frequency, duration, and any associated factors (like stress, diet, or sleep patterns). This information can be invaluable for your healthcare provider.

- Lifestyle Modifications: While awaiting further evaluation, consider lifestyle changes that may help manage your symptoms. This includes maintaining a healthy diet, staying hydrated, managing stress, and ensuring adequate sleep.

- Emergency Care: If you experience any new or worsening symptoms, such as prolonged weakness, difficulty speaking, or severe headaches, seek immediate medical attention. These could be signs of a more serious condition.

Conclusion
Your symptoms warrant careful evaluation due to the potential for serious underlying conditions. While transient episodes may resolve, they can also indicate a risk for more significant neurological events in the future. Early intervention and management are key to preventing complications. Please prioritize scheduling an appointment with a healthcare professional who can provide the necessary diagnostic tests and treatment options tailored to your specific situation.

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