Sister has spells of disorientation, trouble speaking, hands and lip shaking, lasts about 20 minutes or so could this be a tia she is 40, overweight, battles high blood pressure, is under a lot of stress. my mom has tia's but her symptoms are very differ

A : A stroke is a brain injury from either bleeding into the brain or loss of blood flow. It is a medical emergency and can cause permanent neurologic injury or even death. A TIA (transient ischemic attack) is caused by a brief stop in blood flow to the brain and can cause stroke-like symptoms which improve after a few hours. It is thought to be a "warning" sign that a true stroke may happen if steps are not taken to prevent it. Three of the most common symptoms are facial weakness, arm drift and change in speech - if she has any or all of these symptoms, there is a higher likelihood that she is having a stroke or tia. The fact that her symptoms are different from your mother's does not rule it out. If she thinks she is having a stroke or tia, she must call 911 and go to the emergency room for evaluation. Quick diagnosis and treatment can reduce stroke severity or confirm TIA where steps can be taken to hopefully avoid a stroke. Obesity, high blood pressure, and stress can all be risk factors, so she should be seen by her doctor as soon as possible for treatment and hopefully prevention of stroke.

Possible migraine: Symptoms could possibly represent migraine attacks. She definitely needs to be evaluated by a neurologist.

A few possibilities: Although the duration might suggest tia, the description raises some concern regarding seizure activity. Certainly, could be associated with hypoglycemia, or even a migraine aura. To sort out, see a doctor soon, get fully assessed, as all the above can be treated and controlled.