Sunday, January 1, 2012

Help from the Hive Mind: weird medical question

I need thoughts, ideas, and relevant personal experiences.

Apparently my mom woke up yesterday morning in pretty bad shape. The primary symptoms seemed to be a profound sense of vertigo, and high-grade nausea (probably as a result of the vertigo). In addition, she can't hear out of her right ear at all. My dad called their doctor (who seems perfectly competent, as far as I can tell), and told him about the symptoms, and he prescribed some medication which seems to be helping with the dizziness (and hence the nausea).

So, you know, so far, so good.

Upon coming over to visit today, I found that the right side of my mom's face is... slack. I hadn't been expecting that, and immediately wondered if she'd had a stroke. On further inspection, I don't think so - but I'm not a medical professional, I only know what I read. And this is sufficiently disturbing that I'd like to get some input from you guys.

Here's the information I'm working with:
1. The side of her face isn't numb, it's just slack. This effect seems to extend from up around the right eye, down to the chin; it's giving her trouble drinking water, rather as if she'd just come home from getting a filling at the dentist's office. (She hasn't.)

2. Part of that area, maybe most of it, seems to be oddly swollen. Now, her lower lip has been swollen for a couple of weeks - nobody seems to be sure why. Anti-chapping balm has cured some surface chapping but not affected the swelling at all. This new, wider area of swelling appears to extend from the lip, across the cheek, and up to the cheekbone; it's particularly obvious where it reaches the bottom of the cheekbone.

3. Yesterday's medication (apparently some sort of next-generation dramamine equivalent) has resolved most of the vertigo, and that seems to have cured the nausea as well. She can eat and drink, and keep her food down.

4. She still can't hear out of her right ear, but her right eye seems to be working fine: she has full binocular focus, and as far as I can tell no drifting of the eye or delay in response time, or anything like that.

5. She is oriented as to place, time, and events; she has a very slight slur (about what you'd expect when one side of your mouth was numb) but is otherwise perfectly capable of speaking clearly. She also has no trouble understanding, following conversations, responding appropriately, etc.

6. Her doctor seems to think it's a blockage in the Eustachian tube. He's apparently trying to get it to drain.

7. My mom is post-polio, and cannot move her legs. She normally walks with crutches and braces. This is probably irrelevant here, but might be worth mentioning.

Here's my current hypothesis:
I don't think this is the aftermath of a stroke. It's possible, but I don't think that's what's going on. But I'm not a medical professional, so what do I know?

I think this may actually be the result of a bacterial infection. Mom's lower lip has been swollen for two weeks, now. I'm thinking that maybe the infection has spread, causing more swelling, which is currently squeezing off the Eustachian tube (and possibly part of the nerves in the face) and thus causing the more obvious symptoms.

So here are my questions:
1. Does that hypothesis seem at all possible?
2. Are there any other possibilties that I'm missing? If so, how likely are they?
3. Have you ever run into anything like this before? If so, what fixed it? (If we can clear the whole thing up by, say, having her down a glass of lemon juice, I'd love to know about it.)
4. Any other thoughts or ideas you'd care to contribute?

Cross-posted on the ULMB


  1. Does she have any fever? Redness? Blockage in the Eustachian tubes can definitely be caused by an infection. Have you asked him about putting her on antibiotics?

  2. No noticeable fever, but she isn't and hasn't been on antibiotics - I'm going to push for that soonest.

  3. Bells Palsy is my guess. Maybe brought on by an inner ear infection.


  5. I second bells palsey. I have a friend who currently has this. Some similar symptoms.

  6. Okay, as of the middle of last night (so, um, about eight hours ago), the CT can looked fine, the heart thing (EKG, if I remember right) looked fine, the bloodwork and urinalysis looked fine. So, Mom was transferred from the emergency room to another building within the hospital.

    The plan at this point was to get... I think it's a MRI - a more detailed, complex scan of the brain, anyway. (Sorry, I'm barely awake, I can't process acronyms before coffee.) Since that put Mom in a room with a roommate, Dad and I went ahead and came home after we got her settled in. That would have been just before midnight; I got home about midnight thirty last night.

    The last doctor before we left - the one in the stroke/neurology specialty building - said that he didn't think it was a stroke (but I wouldn't read too much into that; I think it was a pretty qualified comment, just saying that it didn't look like a regular stroke *as such*). And he was willing to listen to the possibility of the lip infection having something to do with this.

    My brother and his wife are headed over there now, to visit and find out what the current results and assessment look like.

  7. They're not looking at Bells Palsy at this point, because of the hearing loss. If it weren't for that, they would have diagnosed it as Bells Palsy immediately.

    Could still be, but the combination with the hearing loss apparently could involve a pair of closely related cranial nerves (7 & 8), which is why they've been digging around in the neurological stuff.

    But there's always the possibility that we have more than one thing going on at the same time.

  8. My guess is what was causing the swelling of her lip may have spread to her inner ear, causing an inner ear infection. Which would explain the vertigo, nausea, and hearing loss.

    Hope your mom gets better!

  9. I was going to say bells palsey as well. Whatever it may be I hope it is figured out soon so she can resume her normal activities without the swollen lip and numb mouth.

  10. As of... I don't know, an hour or so, here's what we've got:
    They're doing a second CT, this time with contrast, to make sure there isn't any sort of "brain bleed". The MRI has been done, but apparently there's been a huge run on the machinery, and we won't get anyone to actually *read* it until tomorrow.

    The upshot is that Mom will be staying there for another day, and we should have more information in the morning.


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