If a person can't talk, she may be having a stroke which is a medical emergency.

I have episodes of aphasia which are not stroke. My neuro told me that when the episodes occur, I should always go to the er because even though I have non stroke aphasia, I could still have aphasia as a symptom of stroke so the events should be assessed in an er in case stroke treatment is warranted.

Here's the problem. If I go to the er, I am always asked if I have ever had aphasia before. As soon as I confirm that I have, the triage nurse decides that I am not having a stroke. No exam is performed. Sometimes, I don't see a doctor until well past three hours. Once I was actually thrown out of the er altogether.

I feel like the boy who cried wolf. Most likely the event is not a stroke but if it is , I won't receive appropriate care within sufficient time. Any thoughts on what to do?

Hi Helen!

The neuro is correct. My opinion is that you wouldn't tell them of past episodes so you would get the fair treatment you deserve.

I am really not understanding how they would not take it seriously to begin with. I would be going to another hospital.

What is the neurologists take on the matter? Have you told him of how you have been treated in the ER?

Bluemoon, thank you for your reply. This has happened at several hospitals. The neurologist was very upset but we figured we couldn't fight city hall. The time I was "evicted" from the er, I couldn't talk or walk. After my shoulder surgery, I couldn't talk in the recovery room for about an hour. The nurse was not concerned at all. The doctor actually spoke to my neurologist and told her that there was no way for me to be seen by a neurologist.

I don't know if I am capable of saying that it has never happened before. I have a new neuro and I plan to discuss this with him also. The first time I couldn't talk, I was taken seriously. I got my speech back by the time the ambulance arrived at the hospital but I was carefully examined for stroke. I was admitted for observation and I wasn't discharged until I had an mri (normal).

I have had several mri's since this started happening and they have all been normal. My dx was complicated migraine. If I get 2 symptoms from a group including ataxia, aphasia, double vision, and confusion, then it is basilar migraine. The neurologist and I think that Tamoxifen was triggering the neurological symptoms and since I stopped taking it 3 months ago, the only problem I still have is episodic aphasia.

Hello Helen,

Is your neurologist taking precautionary steps against ischemia, just in case?

I know my original MRI was normal, then later they were not. I am sure you doctor is hoping that you have not had a 'transient ischemic attack'. No doctor wants to see this for his patient.

Take care

Helen,

One more thing I would like to ask. Are you feeling ill/sick when these things are happening? I was very sick to my stomach and disconnected with the world around me. I could not process what other people were saying/asking me to do.

My speech was slurred, my face was drooped and I couldn't stand or raise my arms.

I feel absolutely fine when the attack occurs. I might be in the middle of a sentence when suddenly the words just stop coming out. It is totally shocking. There does seem to be a consensus that if the attack should last more than an hour, the situation is more serious. That only happened once but it was a little different because after an hour my speech kept coming and going. That was the time I was ejected from the er.

There has definitely not been any TIA. A TIA would show up on an MRI. All my imagining has been normal after several of the episodes. Every test I had was normal. I was taking Plavix for about a year but my new neuro said it was not necessary. One of my doctors who is not involved in my treatment of neuro problems puts it this way. He says something is definitely wrong with the arteries in my brain but the good news is that since the imaging is normal, there has been no brain damage and the truly awful conditions can be ruled out.

My neurologist says that the episodes are a manifestation of migraine with aura. Medical literature does support that.

I appreciate your interest.