I had a 6th grader come in today that I have never seen before. His complaint was that he was having a hard time making sentences and that his R hand had gone a little numb earlier. He had tears in his eyes and repeated a few things.
I don't know this student and you guys all know that we get all kinds of weird complaints. The tears made me think something was going on (such as he forgot his homework and was worried about being in trouble). So I had him call his mom and then I got on the phone with her and she said he wasn't making much sense and she stressed that he is usually really well spoken and takes honors classes. So now I was starting to get the idea that he was really not acting himself. I told the mom to come get him.
After that, I called the teacher that he had come from and he told me that the student had been having a hard time articulating what he wanted. Not really aphasic, but more like trouble word finding. He told me that because he is such a trustworthy student, he told him "Would I say yes to whatever it is you're asking for?" and the student said yes so he said "Just go ahead then" and I'm so glad he came to my office!
His neuro checks and VS were all WNL and he wasn't showing any confusion. When he said he was feeling the numbness again to his R hand, I checked grip strength again and it was even. I asked him to tell me about his morning to see if he had trouble remembering details or trouble saying any of the words. He did ok. But, again, today was the first day I met him. When I described what had happened to another of his teachers and my principal they were both shocked and said that it is way out of character for him.
I am going to call the mom and see how the dr appt went (they were heading straight there from the school). Crossing my fingers that he is OK!
I wonder how they knew it was a mini stroke. Did anything show on studies?
When I talked to the mom on Friday, nothing had shown on MRI or CT. He was having an EEG later that day, so I'm assuming that when it showed. He is having another EEG this Friday to assess for further changes.
That's so scary, OP! I was actually going to guess seizures. They can present in such odd ways. Glad this kid fought through this communication struggle, glad you listened to your instinct, and glad mom was on it as well! This poor kid.... I can't imagine starting on anticoagulation and getting the battery of tests and specialists we send our grown ups to. He's too young to have all of this in his world. 😢
You know, I was thinking CVA/TIA when I first read OP's post. I don't do kiddos, but I was thinking those S&S sounded soooo appropriate for an adult/geriatric pt, but for kids??? Knowing that dx was so atypical for so young a pt did give me pause. But I've always held that ANYTHING is possible in healthcare esp when it come to illness. And I have heard of it before altho it is rare.
I've learned to go with my hunches aka 'listening to my gut' even when I've met with skepticism and resistance. Advocacy can be a tough road to follow.
I hope they are doing more of a work-up. Pediatric strokes are extremely rare, if a kid is having TIAs, something is causing them. Kid needs an MRA or an Angiogram to rule out (or in) things like an AVM, aneurysm, Moya Moya disease. (Spent 5 years in Pediatric Neuro = seen the rarest of the rare diagnoses.)
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When I talked to the mom on Friday, nothing had shown on MRI or CT. He was having an EEG later that day, so I'm assuming that when it showed. He is having another EEG this Friday to assess for further changes.