Signs of facial paralysis, treating doctor to put her through another MRI scan today
Indrani Mukerjea will undergo a series of tests to help doctors ascertain the reason for the spasm
Low blood pressure, facial spasms, headache and dizziness have landed Indrani Mukerjea in JJ hospital. Her treating doctor, Dr Wiqar Shaikh, professor and unit head of medicine, who examined her late last night, said he found signs of paralysis on the left side of her face, which could be due to a stroke she may have suffered earlier. However, to rule out all probabilities, a repeat MRI scan would be done on Saturday morning, Dr Shaikh said.
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Dr Shaikh also said he was concerned about the sudden drop in her blood pressure, which was at 90 /70 mmHg. She has been admitted in the Critical Care Unit (CCU) and has been subjected to routine blood and urine tests, and has been referred to both Cardiology (for drop in BP) and Neurology (for facial spasm and headache). A 2D echo scan of her heart is also likely to be done by the cardiology team at JJ. Interestingly, Dr Shaikh, has treated Indrani on three earlier occasions at JJ, twice for alleged drug overdose and once for chest pain.
Indrani Mukerjea
A battery of tests confirmed that she was diagnosed with Cervical Spondylosis. On Friday morning, Indrani was brought to JJ hospital after the jail doctor S A Khan found her blood pressure to be low. Dr Shaikh examined Indrani and decided to admit her in the critical care unit.
Earlier in the week, Indrani was referred to JJ hospital where doctors examined her for 5 hours and sent her back to prison without any medication (mid-day report on Sept 25, JJ doctors send Indrani's headache packing in 5 hours)
Late evening tests
On Friday late evening, Indrani was made to undergo 2D echo test to rule out any abnormalities or blockages in her heart. A CT angio was also conducted to get clear visuals of the nerves passing through the brain.
Her MRI test, conducted on Wednesday, has already shown two issues - cerebral ischemia, which according to Dr Shaikh, is not normal for a woman of her age, and secondly she has neurovascular compression syndrome indicating hemi facial spasm (CN VII) and Vestibulocochlear Neuralgia (CN VIII). She will be made to undergo an Audiometry test for examining her hearing ability, as her CN VII is compressed on Saturday.
Also her blood test will be done to find out the Homocysteine - a common amino acid level in the blood, a deficiency of which can cause severe damage to the brain and heart. Also her vitamin B1, B6 and B 12 levels will be tested.
Doctors concerned
Dr Shaikh added, "It is a known fact that Indrani was diagnosed for hypertension when she was first admitted in 2015. Since then she has been on tablet Amlodepin 5 mg daily, due to which she was able to maintain a normal blood pressure of 130/80mmHg.
But for last four days she has not taken her hypertension medicine as she was advised by JJ doctor who had examined her on Monday evening and later she had to undergo MRI scan on Wednesday.
When asked if the sudden drop in pressure could be a result of stress, Dr Shaikh said, "Stress usually will lead to hypertension and develop high blood pressure, and present case of Indrani shows her to be in hypo tension stage (drop in pressure), which will require a thorough evaluation to ascertain the reason. It is a matter of concern for us."
Jailor says
Aruna Mugutrao, Superintendent of Byculla Jail, said, "We did not want to take any chance and hence took Indrani to JJ on Monday, but we were made to wait for five hours and still the doctors who examined her did not admit her. We were of the impression that she would be admitted for conducting tests, but she was released without even giving any medicines."
She added, "On Friday, she had a routine visit to meet the neurologist as her MRI report taken on Wednesday showed some abnormalities. But I was later informed that as her BP was low, she was admitted under Dr Shaikh's care." "We cannot ask the doctor to admit our prisoner, but they should have admitted her on that day to avoid any last minute rush to the hospital from the prison," she said.
What doctors say
When contacted Dr Vijaykumar Joglekar said, "Today (Friday) is not my emergency unit, you can speak to the treating doctor." And for not admitting her on Monday, Dr Joglekar said, "I have submitted my report to the hospital dean and medical superintendent, you may ask them. I won't make any comment."
Dr M B Tayade, Dean of JJ Group of hospital and Grant Medical College said, "We had to admit her as her pressure was low and even her MRI had shown neurovascular compression syndrome (CN VII and VIII) and all blood tests, reference of cardiologists and neurology team are evaluating her."
Expert opinion
Dr PP Ashok, senior neurologist attached to Hinduja Hospital, said, "We have to understand the exact location (right or left) of facial spasm to corroborate the MRI findings of neurovascular compression syndrome (CN VII and VIII) to ascertain if the spasm is caused by that very nerve or not and accordingly we will be able to diagnose the issue. And the least this is not a life threatening findings in MRI."
Indrani's medical report card
Heart beat: 65 per minute
Blood pressure: At admission 90/70, and post IV, 130/80
Complaints: Headache, dizziness, facial spasms
MRI report: Cerebral ischemia and neurovascular compression syndrome
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