Dizziness, confused speech, off balance movements, put on Welbutrin. CT, EEG normal, lefts die weaker than right. Any ideas ?
Patient: I have been having trouble for about 7 months. It started out that I would get confused a little very rarely. I thought that it was just dehydration . Then about a month later I started getting dizzy and confused a few times a month. Then all of a sudden it hit hard. I could not make sense of things. When I spoke I was saying the wrong words. Finally my mind seemed to give me trouble constantly. My speech was confused, my movements were off balance, I would forget things that had either just happened or I d forget where I was, and when people would talk to me I had trouble understanding what was being said to me. I have had a ct scan which came back fine, an EEG that came back fine, and a balance test that showed that my left side was weaker than my right. I ve lso lost little bit of my hearing . The neruologist that I ve been seeing has put me on Welbutrin and just said to keep coming back every three months. But I keeps getting worse. Doctor: You must have a repeat consultation with your neurologist and possibly get an MRI scan even if your CT is normal. This is especially because you have hearing loss and weakness in one side of the body. Your symptoms suggest a possible temporal lobe epilepsy or CP angle pathology which requires investigation. If the MRI is normal, ruling out cerebello-pontine (CP) angle pathology, I would even suggest a video-EEG telemetry which, if lucky, could record one such episode of confusion. Sometimes complex partial seizures can be missed on routine EEG if the source of seizure in deep in the brain or in the temporal lobe. Video-EEG may be more useful.