Greetings.
How old is he? Any history of heart disease, high cholesterol, diabetes, high blood pressure? Is he obese, sedentary, stressed, smoker?
Dr. Arun
Hello,
It can be transient ischemic attack (TIA). This is just a small duration decreased blood supply to the brain. This is a warning sign to look for the atherosclerosis or narrowing of the neck arteries (carotids), which supply blood to the brain. The alcohol withdrawal or detoxification is not for short duration and persists longer. With his medical history, one needs to keep an high index of suspicion. If he is absolutely normal he may consider going to a walk in clinic (urgent care) where vital parameters can be taken and EKG can be recorded. He can get the rest of the investigations and medical imaging later on in a routine appointment. That might be less expensive alternative to ER where they may decide to all investigation including echocardiography, MRI or CT scan, blood work etc.
Please read the details about the TIA in this resource;
http://www.mayoclinic.com/health/transient-ischemic-attack/DS00220
An immediate examination by a physician is usually necessary for screening with his symptoms. Investigation, can though, wait.
Please feel free for your follow up questions.
You are most welcome.
These symptoms would warrant to take him to ER, as they are slightly more serious and need a chest x-ray and full cardiology evaluation, I am afraid. A Mallory Weiss syndrome should be ruled out. Please read about it;
http://www.nlm.nih.gov/medlineplus/ency/article/000269.htm
I hope this was helpful to you. If it was, please remember to ACCEPT the answer so I can get compensated for my work. if you have any more questions, please feel free to ask. I am truly privileged to help you, and I want to make sure that you are satisfied with the answer. Good luck!
ok, I read the link about mallory weiss symptom, and it said the symptoms include bloody stools or blood in the vomit. It also said that the tear usually heals in about 10 days without treatment. So I am wondering why the ER? Can you explain?
Also, what do you think caused the sudden paralysis, numbness, and slurred speech?
The Mallory Weiss may not have blood in vomiting or stool when the laceration is very small. Once it is suspected, it needs thorough evaluation as it may heal spontaneously or tear may get bigger and cause complication. So both the spectrum of prognosis are possible. His symptoms can be due to;
1) TIA; a decreased blood supply to brain tissue
2) Cardiac problem; a heart attack can decrease the blood flow to each and every part of the body.
3) A sudden chest pain unrelated to heart (termed non cardiac) causing fall in blood pressure due to the intense pain and resultant fall in blood pressure and thus decrease blood flow to the brain and other organs.
4) Unrelated to above; some other phenomenon which we may not be able to understand due to lack of physical exam.
The crux is; with his symptoms he needs an examination by a physician. You may consult at urgent care clinic and if the physician decides to send you to ER, for specific reason, you may consider that just to cut the expense.
Please read this link also (under the heading CLINICAL and HISTORY; Boerhaave syndrome), which relates to alcohol intake;
http://emedicine.medscape.com/article/171683-overview
It is pleasure and privilege assisting you.
Doctor (MD)
MBBS, MS (General Surgery), Post-doctoral Fellowship in Sports Medicine
Best wishes and kindest regards,