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It's a long story so I'll keep it as concise as I can.
Few days ago my lad started getting a tingling feeling in his right hand, this quickly progressed to total loss of sensation in that arm as well as total loss of motor control in the arm and hand. He also had an a "really, really bad" headache come on.
He went to A&E.
During his time there, over the course of a few hours (or less, I want there...) the feeling and motor control returned. He was given a muscle relaxant (diazepam) and painkillers I believe as the arm started to hurt as the feeling turned.
He was discharged within a few hours with no definite diagnosis and a prescription for painkillers. Only tests carried out whilst there were blood pressure and testing strength in arm/s and hands by pushing against doctors arms etc etc.
On and off he's still getting the extremely bad headaches (migraines?) and I just asked him to look at the NHS app to see what the hospital put in his notes.
The notes from the hospitals A&E say:
Investigations Completed:
Blood coagulation panel
Blood gases, venous measurement
Bone profile
C-reactive protein measurement
Full blood count
Urea and electrolytes
If Google is correct, all those tests need a minimum of a blood test then the hospital is totally bullshitting. He had no bloods taken. Just blood pressure checked and a few physical strength tests to compare arm strengths, grip in hands etc
Background info and some Google pearls of wisdom:
1) From a post on this form a few years back my biggest worry is that he's had a TIA and the hospital missed it. Given a TIA can be a warning sign of a full blown stroke happening in the near future I'm very worried about this.
2) I have had neurosurgery for Chiari malformation. This neurological condition can be passed on to (generally male) children and symptoms come on in their 20's. My lad is 28. The symptoms he had could absolutely be caused by this condition and are pretty similar to what happened to me. An MRI is almost certainly needed to confirm this one.
3) Though he's never had migraines before, they do run in the family and Google says that some migraines can lad to temporary paralysis.
4) Stress can cause this apparently. My lads a cop and he'd performed CPR a few hours before being taken ill. The person sadly passed away. However, it's not the first time my lad has seen death up close given his job and he thinks this event didn't cause the problem.
5) Could a nerve have somehow been impinged and caused this?
So...
I'm worried. The hospital lists tests being varied out that look to have never been done. I'm most concerned that a TIA took place and hasn't been diagnosed. He's basically just taking painkillers for the headache at the moment and I'm intending to nag him to go to A&E or at least his doctors.
Any informed info on any of this?
Thanks as always.
Where they made aware of the family history (i.e. you)?
Are there any figures against those tests?
I would guess that it was a migraine. As a teenager I used to get migraines that would cause my entire arm to go numb, and half my face, followed by extremely severe headaches. I had grown out of those sort of migraines by the age of 28 though.
I suspect that preforming CPR was probably the trigger, migraines typically strike after a period of stress as the person is unwinding.
Sounds reasonably similar to what happened to me. Massive headache like someone had put a 6 inch nail into my head, loss of vision, numbness, confusion. Root cause was TIA from by a ruptured carotid. I was very lucky as an MRI picked it up as I could quite easily have died without proper treatment. I’d Really press hard for that MRI. I still have the migranes but now much reduced. Have you checked his cognitive function? A MoCA test would be the thing for this and you could probably do it at home. I had a stunningly bad score and took a couple of years to recover.
Take him back to A&E for the on-going head pain, and you explain the genetic history.
Do you have an equivalent to this? healthdirect Symptom Checker | healthdirect (it's a clinician verified decision tool that will recommend what to do next)
I'd be going to the GP and making sure they got the full history. Write it down first so it's all there in front of him, including any questions he might have.
No advice to add to the above, but I hope he gets the follow up advice or tests he needs. I can see how worrying that would be.
are you certain no bloods were taken? I would expect those tests as a minimum and it would be gross professional misconduct to say they had been when they were not. on the computer systems I used it would also be impossible to actually do that
I would have expected a cat scan tho
if you are certain then a formal complaint is certainly the correct thing to do not least together to tighten proceedures
I don’t think going back to A&E is necessarily helpful. But I would be on the phone to my GP - I know getting an appointment can be hard, but a persistent headache for multiple days and presumably an instruction from A&E to see GP if symptoms don’t improve should see you get in front of all the people who have a cold.
I'm so sorry that you're going through this, a family member has had something similar and neurological symptoms can be difficult to pin down.
I'm in no way medically qualified, but here's a quick rundown of the experience:
GP: too many potential diagnoses, but some stroke symptoms. Go straight to A&E
A&E: not a stroke, might be TIA, straight to out-patients stroke/TIA clinic for the rest of the day. Not TIA, discharged
This is where it became a problem. Head scans only, discharged and they didn't refer on for further investigation
Back to GP: we'll refer you for head and neck MRI. We paid for a private MRI (about £300) the same week which showed problems lower down
Admitted to neurological ward where full investigation, treatment and tests over a week
The bottom line: keep plugging away if you're not happy. The key for us was the private MRI, but that's neither applicable nor possible for everyone
Hope it goes well for you all
At least phone the NHS 111 and see what they say.
I had some really bad experiences with A&E and my GP when I badly broke my pelvis and hip socket. It was only six weeks later after being told nothing wrong, GP wouldn't see me, private physio said we think you've fractured your hip, back to A&E, xray nothing broken, showed physio etter, hours later CT Scan, hours later, 'how the hell are you walking', admitted immediately, smashed pelvis, referred to specialist with prospect of needing a new hip immediately. Oh bit long ago now, let's see how it heals. No weight bearing for 6 weeks. Bit late been on holiday and back to work for six weeks already.
111 or back to A&E if symptoms persist.
If a TIA, aren't these mainly the result of atrial fibrillation - so his heart rate should be checked?
I didn't get anything close to migraine symptoms when I had mu TIA, so maybe it was a migraine as per ernielynch's post.
Some of the symptoms (sorry if this is a bit alarmist) are similar to what my mate had leading up to being diagnosed with MS. Only a brain scan can pick that up I believe.
Hope all ok and it was just a one-off!
Doing CPR is pretty physical, isnt it? Has he had a neck injury before?
A&E is not the place to get an MRI, or even get a follow up referral, he would have been triaged out of there as soon as his symptoms resolved.
Migraine is likely, TIA is possible but unlikely at 28yo, and yes Chiari malformation is possible too. The GP is where your son should be going, with your good self, to ask for further investigations, making my concerns re TIA very clear, as this is the most life threatening, and then the Chiari malformation and then the migraines. I wouldn’t be leaving without an onward referral for a CT head at the very minimum, ideally an MRI and some kind of plan as to where to go from there
I went A&E 3 months ago and blood was taken upon arrival also ended up with a CT scan, prescriptions and the ENT doc who was called into A&E on a Sunday to see me as they don’t usually work in A&E on a Sunday told me they will be in touch for a follow up appointment. Got a phone call 2 days later with an appointment to be seen again.
Thanks, I've read all the replies.
Son managed to see GP this morning. She isn't happy that the A&E never carried out the tests that they say were carried out.
She's referred him "urgently" to neurology but that can be a month.
Given him more pills to treat the migraine.
I was just to come on and post a response, but it looks like things are moving in the right direction.
If you havent had an appointment through in roughly 3 weeks time, politely chase it with the Practice. Unfortunately all the GP can do is refer, but then its in the hands of the acute trust where the sausage machine can be taxing to say the least
^^ Thanks mate, that's what I will be missing my lad to do.
Must admit, I really don't like bad mouthing the NHS, I know it's under huge pressure and I literally owe it my life.
Does your local hospital have its own app? Mine does and you can see test results via the app on your phone (results that you can't see on the NHS app). Might be worth having a look to see if they have put results to the fictitious test......
Incidentally, the whole app thing is a PITA, I have to have 2 separate hospital apps and the NHS app to get my test results. My GP can't see all my test results and sometimes requests the same tests that the hospital has done just so they can see the results.
Must admit, I really don't like bad mouthing the NHS, I know it's under huge pressure and I literally owe it my life.
Mrs FD and I both work in the NHS, and so do a few of our friends. We all unfortunately know the system is broken. We have all said too that its no longer 'fair / equitable' ie if you want to get anywhere quickly you either have to pay privately or be prepared to gently push where you can to get treatment / answers. That isnt que jumping or anything. it can be that there are so many 'urgent' referrals that take president that a less urgent referral can take months, as the 'urgents' keep bumping it.
eg an urgent may be 2 week, a not so urgent 4 weeks and routine 10 weeks. The 4 weeks can get lost in the system because thats how they are coded, but the urgents keep bumping them.
I'm a GP, but also have extensive hospital medicine background - I agree with your own GPs concern/frustratin.
I'm very surprised that with a new onset headache post exertion, and very focal neurological findings, that he didn't ahve an urgent CT brain to rule out a structural issue. At the very least a CT brain should have been arranged through ED. following this, ED should have referred as an in patient for further testing.
Headache + acute neurological findings = NOT GP TERRITORY
DrP