Questions posted in the Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.

Subject: Re: MIGRAINE?
Forum: The Neurology and Neurosurgery Forum
Topic Area: Headache
Posted by CCF Neurology W6 MD on November 20, 1998 at 18:19:56:
In Reply to: MIGRAINE? posted by Rosa on November 19, 1998 at 11:17:57:



Hi, I posted on 11/17 (Tuesday) under Vasculitis vs. cerebritis. Thank you for your thoughtful response. However, The reason I was concerned and posted on Tuesday was because the night before (Monday night) I could not lay my head on the pillow because my scalp was so sore. I 've posted before here about that also. When I woke up the next morning (Tuesday) I had a severe headache in addition to the scalp soreness - if I touched my scalp I had radiating pain all over my scalp and my face to around my nose. Had jabbing pain in my temples and behind my eyes, problems focusing my eyes and dizziness - sitting and walking (I thought it was typical migrain symptoms). But what really frightened me was that, in addition to the above, later that evening (Tuesday) after originally posted (re:vas. v. cereb.) I had episodes that felt like someone hit me in the head real hard and I felt like I lost consciousness for for a few seconds (felt like I was fainting). Afterwards, I felt faint, weak, and I couldn't walk. This happened about two o three times an hour. I called my neurologist. When he called me back and I explained what was happening and he said - its migraine - call me back if it gets worse. However, I seen on one of my reports in his office, that he'd written "possible vasculitis." When I went to see my therapist on yesterday (Wednesday) she noted that I was a little off (her words) - slowed speech and thoughts, couldn't find words, memory, etc. She said my cognitive problems were worse. I was wondering do these symptoms sound like migraine or could this be something more serious. My next appointment with the neurologist is Nov. 30th. If this is something more than migraine, I don't want to have seizures or a stroke while I am waiting. I am still having the headache. I hope I'm not making too much of this, but I know with lupus (not active) anything could happen. Thank you for your time!

=

Dear Rosa,

thank you for the question.
Migraine is a peculiar disorder. Complicated migraine, ie migraine with neurologic symptoms is a diagnosis of exclusion. Especially in someone with risk factors of other mimickers such as stroke/TIA (mini stroke), or seizure. Depending on your age, seizure or ministroke can produce very similar symptoms. Headache however is uncommon in either one. In light of possible lupus or lupus diagnosis, vasculitis is a good possibility. As I mentioned earlier the gold standard for diagnosis of vasculitis if angiogram, some even had biopsy. At any rate treatment is with steroid. An MRI is helpful especially if it discloses multiple small stroke in different areas of the brain. Yes, you should keep your appointment with your neurologist.
Good luck and Ihope this helps.

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