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@guyrien

My wife is in her early 50s. In very good health. No smoking, just social drinking (4 oz a night), just 10-15 pounds above her high school weight.

About 3 years ago she had some facial twitching and slight speech slurring. She was in her late 40s and didn't realize it was her first mini-stroke. Recovered within an hour or two.

About 1 year ago she had a major episode. Speech slurring, severe facial twitches. Taken to ER and kept over night. All tests/scans returned negative. So just put on blood thinners and cholesterol meds. Doctors think it was a mini-stroke but no damage per scans.

Today she had a third event. She had gone off her blood thinner for a week as it was causing lots of bruising and she was going to talk to the doctor about a replacement. This was a slight event. Face/arm/lips were numb. Fully recovered with 2 hours.

All events effect her right hand side.

We are at a lost what to do. She feels like a ticking time bomb.

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Replies to "My wife is in her early 50s. In very good health. No smoking, just social drinking..."

Her health team must be apprised of the lastest event, and of the previous one and when it took place if they don't already know. Sadly, and I am not a health expert, not a physician, but it does sound to me like a TIA. About all you can do for now is to read up on TIAs, what if any treatment can be undertaken, including prophylaxis, which is almost always a DOAC (Direct-acting Oral Anti-coagulant), and what she (and you) can/should do in order to stem their onset in the future.
These signs are often an indication of systemic inflammation. The adhesion of plaque and thrombosis are both exacerbated by inflamed tissues, including portions of the vascular system. Your physician and perhaps a neurologist will know where to take this from here.

What did her MRI show?

@guyrien, my first thought was for your wife to ask her primary care provider or neurologist to schedule an MRI asap. That could eliminate that ticking time bomb feeling for her. Once you know, you know. Depending on what is discovered, she may be referred to a cardiologist as well. As for blood thinners, I remember my dad had to be careful what he ate and drank (no alcohol) while taking them. You may want to check on that.
Once you two know what you are truly dealing with, you can attack a plan to prevent a stroke in the future. No guarantees, but we stroke survivors give it all we've got and pray for the best. I encourage you two to do the same. Hope you get good results!