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Have mini-strokes while sleeping, dizziness, difficulty balancing and speaking. Treatment?

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General & Family Physician
Practicing since : 2001
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Hallo, I live in Calgary, Canada and have a question regarding my 83 year old dad who lives in South-Africa. According to his GP, he gets mini-strokes while sleeping and he will wake up during the night feeling dizzy and disorientated. Being so far away, it is difficult for us to monitor his health properly. He has difficulty with balance [permanently] and often [when tired especially] he will have difficulty speaking. Other days his speech is good. I would guess that he needs to go for a proper examination with a specialist and get a CT scan done. Would there be treatment available to prevent these mini-strokes, as we fear that it can lead to a bigger stroke. It seems that he doesn't want to go through all the tests, scans etc, but without it, steps cannot be taken to treat him. He is fairly healthy, heart is fine [according to my dad], blood pressure good as well. He isn't on any serious medication, just the occational pain relief for joints etc. Unfortunately he had a few falls this past 2 years, seems it happens when he is dizzy and loses his balance. Your advice will be appreciated. Thanks. XXXX from Calgary.
Posted Mon, 26 Aug 2013 in Stroke
Answered by Dr. Michelle Gibson James 55 minutes later
HI, thanks for using healthcare magic

Your concern is understandable and warrented. There is an increased risk of a major stroke in persons with a history of small or minor strokes.

A stroke occurs when a part of the brain does not receive enough blood. This can result from a blood vessels becoming blocked or from rupture of a blood vessel.
It is more common to have a stroke from an obstructed vessel than from a bleed.

The risk factors for stroke are : (1)previous history of stroke,
(2)high blood pressure particularly uncontrolled blood pressure,
(4)high cholesterol,
(6) alcohol use,
(8) physical inactivity,
(9)history of problems with the circulation.

If he can adequately control most if not all of these risk factors it would reduce the risk of a stroke.
His blood pressure control should be optimal with the systolic 130 or less and the systolic less than 80 and his cholesterol values should also be controlled.

He may also want to consider the use of aspirin to reduce his risk.

At his age there is the potential for a fall to result in a fracture due to the decrease in bone density so if it is possible for him to determine the cause of his dizziness and possibly treat it then it would be advisable.

Dizziness can be related to different factor including:(1)dehydration, (2)palpitations,
(3)orthostatic hypotension (drop in blood pressure on standing),
(4)side effect of medication,
(5) neurological disease,
(6)conditions related to the inner ear which is involved in maintaining balance.

Evaluation of dizziness would require physical examination, history and appropriate tests based on the results of the findings , for example if palpitations precede the dizziness he would need an ECG.

I hope this helps. Feel free to ask any other questions

Above answer was peer-reviewed by
Follow-up: Have mini-strokes while sleeping, dizziness, difficulty balancing and speaking. Treatment? 35 minutes later
Dear Dr XXXXXXX thank you very much for your reply. You have supplied a very detailed reply, it is much appreciated.
Calgary, Canada
Answered by Dr. Michelle Gibson James 5 hours later

Feel free to contact with any other queries
Above answer was peer-reviewed by
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