Howard LeWine, M.D., is chief editor of Internet Publishing at Harvard Health Publications. He is recognized as an outstanding clinician and teacher and is a recipient of the Internal Medicine Teacher of the Year award at Brigham and Women's Hospital. Dr. LeWine continues to practice Internal Medicine; most recently he became a hospitalist after practicing primary care for over 20 years.

Question:

I recently went to visit my mother, who is 68 now. While I was there she had an episode where she began to have difficulty talking, like she was drunk or something. She also became clumsy and could not move around very well; it looked like she couldn't use her left side. This all came on suddenly as we were eating breakfast, but resolved after about 30 minutes. My mother denied anything was wrong, and told me that these episodes have been happening every few days over the last three to four weeks, but they always resolve and that is why she is not seeking help. She has some trouble with her blood pressure being high, but no other health issues. What could these episodes be? What should she do if it happens again -- should she seek immediate help, go see her family doctor, or wait to see if they resolve again?

Answer:

The symptoms you describe are most consistent with a TIA, short for transient ischemic attack. A TIA is a temporary interruption of blood supply to part of the brain. The reason for the interruption in blood supply could be caused by

• A narrowing in one of the arteries in the neck,

• Small pieces of clot that originate in the heart or some other place in the vascular system, or

• Slow blood flow to part of the brain because of blood pressure getting too low (less likely).

It is important that anyone experiencing symptoms suggestive of a TIA seek immediate medical attention. The risk of a stroke is highest right after a TIA.

Migraine also can cause these symptoms, but it would be an unlikely cause in a person over the age of 60, especially if the symptoms are not followed by a headache.

Encourage your mother to read this and call her doctor now, even if the symptoms have not recurred.