Is It a Stroke Warning?

Q:  Occasionally, probably half a dozen times in the last couple of years, my arms and shoulders very suddenly start to tingle and get very weak. These spells last probably less than a minute. I'm concerned because I understand that a warning sign of a stroke is like this. American Heart Association literature however states that these "spells" occur on one side only.

My first question is: Do you think that these "spells" involving both sides are stroke warnings? Also, if these are stroke-related, should I see a cardiologist, neurologist or whom?

A:  A transient ischemic attack (TIA) is the medical term for a stroke warning in which the patient has symptoms from decreased blood flow in a small area of the brain. TIAs usually last about 10-15 minutes and definitely less than 24 hours. A TIA is a warning sign of stoke just as angina may herald the risk of a heart attack. About 50% of people who have a stroke do so within a year after their first TIA.

TIAs are caused by bits of blood, cholesterol, and tissue that break off from a blood vessel or from the heart and travel to a distant smaller vessel, plugging it up transiently. Because we have arteries on both sides of our neck supplying the brain, it would be rare to have both sides simultaneously throw off little clots. That's why symptoms of numbness, weakness or blindess occur on just one side of the body.

So, in answer to your first question, your symptoms do not sound like TIAs. Hyperventilation or arthritis in your neck could provoke a spell like you describe. I suggest you start with your primary care physician in seeking an explanation.

"Dear Doctor" is a compilation of patient questions answered by doctors from the Medical College of Wisconsin.