Symptoms of brain stem transient ischemic attacks

What are the symptoms of brain stem transient ischemic attacks? 

Transient circulatory insufficiency in the vertebrobasilar distribution causes brief episodes of brain stem dysfunction characterized by a more patchy and variable presentation.

The symptoms of the recurrent attacks may be identical or varying in detail.

In basilar artery disease, each side of the body may be affected alternately.

All of the structures in the same ischemic distribution may be affected simultaneously, or symptoms of brain stem dysfunction may spread from one region to another.

The symptoms may then end abruptly or fade gradually.

They are often premonitory symptoms of impending brain stem strokes that may result in devastating consequences. 

Transient brain stem ischemic attacks affecting the medulla occur particularly often. Vertigo, dysarthria, dysphagia, and tingling around the mouth suggest dysfunction in this region.

At pontine levels, frequent symptoms are vertigo; imbalance; hearing abnormalities; tingling, numbness, or weakness of the limbs; and diplopia. Midbrain ischemia may cause diplopia, ataxia, sudden loss of consciousness, and weakness of limbs.

Symptoms of brain stem ischemia are usually multiple, and isolated findings (such as vertigo or diplopia) are more often caused by peripheral lesions affecting individual cranial nerves.

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