An old friend of mine who happens to be a doctor gave me the advice that anytime anything seems wrong and there is no accompanying pain, that's the time to seek immediate medical help. If you can't pick up your coffee cup because your old arthritic elbow feels like someone just pushed an icepick through it, it might hurt and be a nuisance but it's rarely a life-threatening situation. If you can't pick up the cup and nothing else seems wrong, time to call 911. The problem with driving yourself to the ER (in addition to maybe getting worse and crashing and burning enroute) is, as Mr. Ed pointed out, the ER may be jammed and you get discouraged waiting (and symptoms go away). The responding paramedics are far more likely to see what is going on and will have the ER ready to treat you when they unload you. An ambulance ride is costly but not something that most of us will utilize often so don't dismiss it's value. Getting to the hospital quickly can often mean the stroke is relieved and little to no damage is done and you can return to your normal life. Nobody like having to take a lot of medications but hard work by dedicated physicians have provided us with miracles in bottles that can give us decades of continued healthy living.