Are worsening symptoms post-stroke an emergency?

Wibit asked...

My uncle had a stroke five months ago. Afterwards he had weakness on one side but apart from that was pretty much as he was before.

Over the last month he has started to get much worse. He makes involuntary mumbles that started out when he wasn't concentrating but over the last couple of days he even does them in his sleep.

He can also no no longer hold a glass of water - this too has happened in the last two weeks or so. He is also bobbing his head and can't seem to hold it straight this has been happening for the last 2 months.

On the whole these symptoms started 3 months post stroke and have been getting rapidly worse he has particularly deteriorated over the last week. He is now not eating or sleeping.

We have taken him to his Doctor but the Doctor is not really interested - Am I right to push this as an emergency? Does anyone have any idea what is happening?

We are all just so worried about him!

Expert Answer

James Castle, M.D. is a neurologist at NorthShore University HealthSystem (affiliated with The University of Chicago) and an expert on strokes.

You are absolutely right to be concerned, and it is unacceptable to simply look at this as a natural progression of his original stroke. Strokes are virtually always worst within the first 2 weeks. It would EXTREMELY uncommon for a stroke to worsen this far out, and therefore makes me think that something else is going on. He could have either suffered another stroke, or have some other long term complication such as a medication side effect or infection (pneumonia, urinary tract infection, etc.) If you are unhappy with what his Primary Care Physician is telling you, I would either see another physician or take him to an Emergency Room for evaluation and further work-up. At a minimum, he needs routine blood tests, urine sample, head imaging, and a review of his medications. A chest x-ray might also be warranted.

Your suspicions are correct. This is not normal. I would act on it right away.

Good luck!