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

Question Title: brother's unilateral numbness, headaches, vision problems etc.

Forum: Neurology Forum
Topic: Neurology - General


I'm online trying to do some research for my brother, who is having some troubling symptoms.

For about 8 months he has been experiencing headaches (left side) and facial numbness (also
left side of face). He sometimes has stiffness and numbness down the left side of his neck.
The vision in his left eye is affected -- he sees shimmery mirage images in his peripheral
vision.

He has trouble focusing/concentrating, and trouble with memory loss. He is a partner in a
law firm and is becoming increasingly depressed and discouraged about these symptoms in
particular.

I believe all of these symptoms are fairly constant.

Fortunately his neurologist did not see anything on his MRI and thinks it may be migraines.
He prescribed an anticonvulsant (same as antiseizure?) medication and Elavil, which my brother
couldn't tolerate. He is reluctant to take the anticonvulsant. Guess he's reluctant about
meds in general and doesn't understand why this one is necessary.

He lives in a rather small city, and honestly, I worry that his neurologist may not be the
best. Would it be worth his time to have another
neurologist examine the results of his MRI? Guess I'm just a worried sister, period.

Any feedback and help would be *greatly* appreciated.

Barbie


Thanks for your questions. The symptoms described in your message could potentially be caused by migraine headaches. The most common features of migraines are "pounding/throbbing-type" headaches, frequently associated with nausea/vomit, photophobia (discomfort with light), sonophobia (discomfort with sound). The headaches can be preceded by "auras", frequently visual ones (flashes of light, bright wavy or jagged lines). The migraine attacks usually lasts from 8 up to 48 hours, and during that period, patients usually seek a dark and quiet environment. Less frequently, the migraines are associated with other neurological signs such as vertigo, focal numbness/tingling/weakness. The medications prescribed to your brother, namely an anti-epileptic and Elavil are often used in both migraines and tension-type headaches. Other classes of medications often used are the "tryptans", the "ergots", and also acetaminophen (Tylenol). If the migraines are very frequent (more than once a week), prophylactic medications such as calcium-channel blockers or beta-blockers are used. Unless your brother's symptoms have worsened or changed in character/presentation recently, a repeat scan is not necessary. However, if he feels uncomfortable with his current therapeutic management, these issues should be initially discussed with his physician, and possibly a second physician.

I hope this information is useful. Best of luck.

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