Q. What is Sheetal’s most likely diagnosis? Select true or false for each of the options listed below.
Q. What is Sheetal’s most likely diagnosis? Select true or false for each of the options listed below.
A brain tumour – False – because the symptoms would have come on gradually and are unlikely to resolve within minutes.
An inner ear infection (vestibulitis) – False – this would not cause double vision (diplopia) or slurred speech (dysarthria).
Migraine with a neurological aura – False – this is unlikely because although she does have a past history of migraine, there was no headache, nausea, or flashing lights in her vision and the symptoms did not come on in a stepwise way.
A Transient Ischaemic Attack (TIA) affecting the brainstem (i.e a posterior circulation TIA) – True – the combination of unsteadiness, diplopia and dysarthria would suggest acute brainstem dysfunction. She also has vascular risk factors despite being relatively young.
A Transient Ischaemic Attack (TIA) affecting the cerebral hemisphere (i.e in the carotid territory) – False – Although this might cause slurred speech due to facial weakness, and unsteadiness due to limb weakness, it would not cause diplopia.
A stroke affecting the cerebellum – False – because the symptoms completely resolved within 24 hours.
A brain haemorrhage – False – this is very unlikely to cause symptoms which resolve within a few minutes.
Page last reviewed: 18 Jan 2021
