Scott Street

Stanley
Co Durham
DH9 8AD
Tele: 01207 232384

Hospital :Private Hospital Clinic: Neurology Consultant:

Referring GP: Practice Code: A83016

Dr Dina Elkhatib

Patient Details

Title: Mrs Date of Birth: 07 Mar 1972

Surname: Stobbart NHS Number: 401 147 8032
First Name: April Hospital Unit Number: A433645

Tel. No: 01207 281366 Usual Address:

28 Greenhills
Quaking Houses
Stanley
Co Durham
DH9 7FB

Private Referral

Our Ref: DE/MA

Date: 17 Aug 2023

Dear Colleague

I would be grateful for your help with this 51-year-old lady who has had some complicated symptoms
intermittently over the past two years.
During the episodes she experiences blurred vision usually in the left eye and a tingling feeling which is
most often in the left arm or leg but can be in other parts of her body, she also describes a tremor. These
symptoms have tended to be accompanied by abdominal pain which has been the main focus of our
investigations over the last two years. A gallstone has been discovered but it is doubtful as to whether
this is the cause of her pains.
Episodes tend to last four to eight weeks and the intervals in between were initially about four months
but they now seem to be occurring closer together within an interval of approximately eight weeks.
Having found no satisfactory explanation for the abdominal pains my colleague did prescribe some
duloxetine for her which made a big impact on the abdominal pain but has not helped with the other
symptoms. Her periods are still regular, and she is not describing any symptoms we would normal
associate with peri menopause. She did have one episode of very high blood pressure which resulted in a
hospital admission but since antihypertensives were instigated her blood pressure has been well
controlled.

Dr G Thorpe, Dr C Hamilton, Dr R Cowley, Dr El-Khatib, Dr S Astbury, Dr D Tan, Dr T Butler, Dr S Meikle, Dr

S Abbott
The original symptoms have continued since her blood pressure has been under control. She saw an
optician who had detected lateral diplopia and consequently she has been referred to an ophthalmologist
for further assessment, she is due to be seen in their outpatient clinic within the next couple of weeks.
April is primarily concerned that her symptoms may be due to multiple sclerosis. She has had extensive
blood tests done in the last few months and the results are unremarkable. The MRI result are now back
and suggestive of demyelinating and MS.

Many thanks for your help.

Yours sincerely

Dr Dina Elkhatib

Past Medical History

Start date End date Problem

11 Nov 2004 Not ended Morbid obesity (X40YQ)
26 Jul 2012 Not ended Depressive disorder (X00SO)
28 Jul 2021 Not ended Stage 2 hypertension (NICE - Nat Ins for Hth Clin Excl 2011)
00:00 (XaZbz)

Repeat Drugs
Start Date Drug Last Issued
11 Apr 2023 Lercanidipine 20mg tablets - ONE tablet once daily to reduce blood pressure 25 Jul 2023
25 Apr 2023 Losartan 50mg tablets - take one daily 08 Aug 2023
22 May 2023Duloxetine 60mg gastro-resistant capsules - Take one daily 14 Aug 2023
08 Aug 2023 Duloxetine 30mg gastro-resistant capsules - Take one daily ( toal dose 90mg ) 08 Aug 2023

Allergies
Date Details
05 Jul 2021 Sensitivity: AMLODIPINE - leg swelling
13 Jan 2023 Sensitivity: LISINOPRIL - Developed cough

Dr Thorpe, Dr Hamilton, Dr Cowley, Dr P Barker