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Image seen directly goes to the bottom right with vertigo and loss of balance

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Last Sunday it has started with a problem with my vision. In short every image I have seen directly go to the bottom right. It latest 10-15 min, then came vertigo , a lack of muscle strength and a loss of balance (always falling on the right). After couple of hours it disappeared to the exception of the headache . I went to the hospital and had exams for 7 hours but nothing conclusive was found.
Headache remains and it has been 3 days.
Would you have any views, insights or pointers for me?


Category: Neurologist, Medical

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Category: Pediatric Neurologist
Dr. Sudhir Kumar is online now

Expert:  Dr. Sudhir Kumar replied 4 Days.


Thank you for posting your query.

Based on your description, I would consider two possibilities:

1. Acute migraine attack- it can begin with what is called a visual aura, followed by headache and dizziness. Headaches may last upto 72 hours in migraine attacks. In rare cases, it can last upto 7 days. In cases of migraine, all tests would come normal.

2. Transient ischemic attack (TIA): In TIA, the blood supply to a part of brain is reduced for a short while. This can result in various symptoms as you described. This happens in the presence of risk factors such as high BP, sugar, cholesterol, homocysteine, etc. An MRI with MR angiogram brain would also be helpful.

Treatment should consist of migraine preventive medications such as Topiramate, divalproex, etc, and may be a low dose aspirin, till the diagnosis is sorted out.

I hope it helps. I would be pleased to answer any follow up queries.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Senior Consultant Neurologist

Dr. Sudhir Kumar
Category: Pediatric Neurologist
Senior Residency, Fellowship: DM, Neurology, CMC, Vellore, 2001
Junior Residency: MD, Internal Medicine, CMC, Vellore, 1998
Medical School: MBBS, Christian Medical College, Vellore, 1995
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