OpenHealth Q&A

Left the ER with more inquiries than clarity: Stroke-Like Symptoms Without a Stroke Diagnosis

**Medications I Currently Use:** - Omeprazole 40mg taken at night - Trazodone, prescribed for sleep, with a maximum dose of 150mg - Gabapentin, administered thrice daily at 300mg for sciatica, though I typically only take it twice a day - Vyvanse 40mg for managing ADHD - Fluoxetine, recently increased to 60mg a week ago - Over-the-counter Zyrtec - Dicyclomine 10mg, taken only as needed - Clobetasol for eczema treatment - Birth control pill, Yaz, if I’m not mistaken **Recent Medical Interventions:** - Received a lumbar epidural injection yesterday for my sciatic pain - Underwent a radiofrequency ablation on my cervical spine a couple of months ago **Symptoms Experienced:** Here’s a rundown of my symptoms that led to my visit. - Headache concentrated on the left side - Bruising/dark circles around the eyes, primarily noticeable on the left side, which appeared just ten minutes before I went to urgent care - Blurred and double vision - Episodes of confusion - Incoherent speech; my friend noted it wasn't slurred but rather extremely slow and soft—I struggled to complete sentences or respond to inquiries - Arrived at urgent care with an uncertain fever - Experienced hot flashes and woke up drenched in sweat that morning - Took Tylenol right before heading to urgent care, after which my fever subsided - Weakness in my left leg - Weakness in my left arm - Sharp shooting pain in my left arm and leg, markedly different from my usual sciatica; this pain radiated from the back of my left shoulder down to my ring and pinky fingers without the normal pins-and-needles sensation - Nausea, accompanied by dry heaving but no vomiting - Sensitivity to light **Detailed Account of the Event:** While sitting on my couch, I felt a severe headache on the left side, accompanied by a strange sensation near my left eye. I checked my reflection in the mirror and noticed unusual bruising around my eyes, resembling dark circles from fatigue, despite having rested well the previous night. Ten minutes later, I was limping due to increasing weakness in my left leg, prompting me to take some Tylenol and then decide to visit urgent care, conveniently located just across the street, since my regular doctor’s office was closed. I drove to urgent care, feeling slightly disoriented. Upon arrival, they checked my vitals, revealing a fever, and observed that my speech was sluggish and I appeared confused, swaying when standing. They insisted I not drive and called upon my friend to transport me to the emergency room immediately, equally threatening to summon an ambulance if necessary. My friend rushed me to the ER, navigating traffic at breakneck speed as I struggled with my words. At this point, I didn’t realize how out of sorts I was, but they promptly placed me into a wheelchair after my friend recited my visible symptoms at the front desk. In the ER, I was quickly evaluated and had my vitals checked again. Although I felt considerably better and my fever had retreated, they documented persistent weakness on my left side. As I lay down, I noticed improvement in my speech within ten minutes. Soon after, the medical staff commenced a series of tests: an EKG, which was normal; a CT scan, normal as well; and an MRI of my brain, which came back clean. While I felt a bit of pressure in my head when moving to the MRI table, that sensation dissipated once I returned to bed. Despite still showing left side weakness, I completed the assessments with improved speech and no headache. The discoloration around my eyes had disappeared entirely. They administered baby aspirin, and after around three hours of observation, I was discharged with instructions to consult my pain management doctor. They proposed a “migraine cocktail”—a mixture of pain medications, but I declined, feeling competent enough to refuse additional medications at that hour. I made it home around midnight, feeling well, although a mild headache returned upon waking the next day. While I still experienced some shooting pain and peculiar sensations on the left side of my face, overall, I felt stable.

Answers (1)

8/30/2025, 11:03:00 AM

OpenHealth AI

It's understandable that you left the ER feeling more confused than reassured given the complex array of symptoms you experienced. While it’s good news that your tests came back clear for acute issues like a stroke, your symptoms warrant a careful approach moving forward to ensure your health and well-being.

Key Points:

1. Symptoms of Concern: You experienced headache, blurred/double vision, confusion, weakness on the left side, and unusual bruising around your eyes. Though no stroke was diagnosed, your symptoms represent significant neurological changes and warrant ongoing attention.

2. Possible Causes: Your symptoms could be related to several factors, including tension headaches, anxiety, medication side effects, or complications from your recent procedures (lumbar epidural and cervical radiofrequency ablation).

Explanation:

The neurological symptoms you experienced (weakness, speech difficulties, and visual changes) can arise from a variety of conditions, including migraines, which the medical team mentioned. While imaging ruled out a stroke, further assessment is needed to understand the potential triggers or ongoing issues causing your symptoms.

Next Steps:

Prioritize Follow-Up Care:

1. Schedule an Appointment with Your Doctor: Reach out to both your primary care physician and your neurologist or pain management doctor. Discuss the full spectrum of your symptoms, especially the left-sided weakness and the visual disturbances.

2. Monitor and Document Symptoms: Keep a detailed log of any recurring symptoms, their severity, duration, and any potential triggers. This can provide your healthcare providers with valuable information.

3. Hydration and Rest: Ensure you are drinking enough fluids and getting adequate rest, especially after such a stressful experience.

4. Medication Review: Discuss your current medications, particularly the recent increase in fluoxetine and the combination of other drugs, with your physician. There may be interactions or side effects contributing to your symptoms.

5. Consider Stress Management: Given your recent medical events and ongoing challenges, incorporating relaxation techniques or therapies may help alleviate some tension, which could contribute to your headaches.

6. Emergency Signs: Stay aware of warning signs that may indicate the need for urgent care, such as a recurrence of weakness, rapid deterioration of symptoms, or new severe headaches.

Conclusion:

Your symptoms are concerning, and further evaluation is essential to clarify their cause and determine the best course of action. By prioritizing follow-up appointments and closely monitoring your symptoms, you can work towards understanding and managing your health better. Remember, it’s okay to seek clarity from your healthcare providers; it’s important you feel comfortable and informed about your care.