Neurological Symptoms: When to Seek Further Testing for Your Mother

I'm sorry, but I need more information to assist you. Please provide additional details or context?

My mother is 47 years old and had facial nerve dysfunction four years ago.
Recently, she has started to experience numbness in her hands and feet (a tingling sensation), especially in the left heel, which feels more numb.
Her toes are also quite numb.
She does not have insomnia at night.
Occasionally, she experiences pain at the back of her head near the neck, as well as left-sided migraines.
Her sense of balance seems a bit off, and sometimes she feels unsteady and experiences dizziness.
Additionally, when she speaks, she often miscalls people or says the wrong words (for example, she thinks of calling my brother but ends up saying something else).
Her memory is not very strong, and she frequently forgets things.
She has seen a doctor, who prescribed "Solaxin" and "Tofranil" for her.
However, we want to investigate further to see if there are any issues with her brain (she has a history of hyperlipidemia and slightly elevated blood pressure), as we are concerned about the possibility of a stroke.
If it is not a stroke, we would like to know if further examinations, such as a CT scan of the brain, are warranted based on the symptoms described.
Should these tests be done out-of-pocket? We would greatly appreciate your guidance on whether additional examinations are necessary and what kind of tests should be conducted.
Thank you very much for your assistance! We look forward to your response!

Xi, 20~29 year old female. Ask Date: 2007/04/15

Dr. Huang Yingzhe reply Neurology

Dear Ms.
Hsi,
Dr.
Huang Ying-Che from the Neurology Department of Tainan Hospital, Department of Health, Executive Yuan, responds:
The symptoms you described are quite "diverse." Some are commonly associated with issues in the brain, while others are more typical of peripheral nerve problems.
I believe it would be best for you to visit the neurology outpatient clinic for further evaluation in order to reach a more accurate conclusion.
Thank you.

Sincerely,
Neurology Department, Tainan Hospital

Reply Date: 2007/04/15

More Info

Your mother's symptoms are concerning and warrant further investigation, especially given her history of facial nerve dysfunction and her current neurological complaints. The combination of numbness in her hands and feet, headaches, balance issues, and memory lapses could indicate several underlying conditions, including neurological disorders.

Firstly, the numbness and tingling sensations in her extremities, particularly in her left heel and toes, could suggest peripheral neuropathy, which can be caused by various factors such as diabetes, vitamin deficiencies, or nerve compression. Given her history of high blood pressure and high cholesterol, vascular issues could also be a concern. The headaches, especially if they are unilateral (on one side), could indicate migraines or tension-type headaches, but they could also be related to other neurological conditions.

The balance issues and episodes of dizziness are particularly concerning. These symptoms could indicate vestibular dysfunction or issues related to the central nervous system. The fact that she sometimes has difficulty recalling names or words could suggest cognitive impairment, which can be associated with various conditions, including transient ischemic attacks (TIAs), which are often considered warning signs for potential strokes.

Given these symptoms, it is advisable to seek further evaluation from a neurologist. A thorough neurological examination will help assess her reflexes, muscle strength, coordination, and sensory function. Based on the findings, the neurologist may recommend imaging studies such as a magnetic resonance imaging (MRI) scan or a computed tomography (CT) scan of the brain to rule out structural abnormalities, such as tumors, strokes, or other lesions.

Additionally, blood tests may be necessary to check for vitamin deficiencies (like B12), thyroid function, and markers of inflammation or autoimmune disorders. If peripheral neuropathy is suspected, nerve conduction studies or electromyography (EMG) may be performed to evaluate the function of the nerves and muscles.

Regarding the costs of these tests, it will depend on your healthcare system and insurance coverage. In many cases, imaging studies and specialized tests can be expensive, but they are often necessary for accurate diagnosis and treatment planning. It is essential to discuss these concerns with your healthcare provider, who can guide you on the best course of action and any potential costs involved.

In summary, your mother's symptoms are significant and should not be overlooked. A comprehensive evaluation by a neurologist, including appropriate imaging and possibly electrophysiological studies, is crucial to determine the underlying cause of her symptoms and to guide treatment. Early intervention can be critical in managing neurological conditions effectively, so seeking further testing is a prudent step.

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