My 14-y.o. daughter has had continuous migraine aura (without headache) since December. It began following a bad reaction to Paxil; after 6 days at 12.5 mg, she experienced full-blown hallucinations. She describes her current symptoms as seeing millions of layers of shimmering white lights all the time, including in the dark, w/ eyes shut, & in her dreams. She has other visual disturbances: colored lights, trails following objects, after-images, distorted peripheral vision, stationary objects moving. She had a normal MRI, eeg, and eye exam (with the exception of an unusual color deficiency). Along with her visual disturbances, she has dizziness, chills, sleep disturbances, and fatigue. In January, she was diagnosed with Postural Orthostatic Tachycardia Syndrome (POTS). However, her electrophysiologist expressed concern that she had a number of overlapping migraine symptoms. We saw a pediatric neurologist whose only recommendations were eliminating migraine triggers and improving sleep hygiene. We are very concerned that we are losing time in figuring out what is causing her visual problems and treating them.

Several years ago, you responded to a 38 y.o. woman with similar symptoms by saying the Cleveland Clinic treats such conditions aggressively, with IV meds. Has this approach been successful? Would you treat a 14-year-old similarly? Is there a particular doctor at the Cleveland Clinic that would be best to see given her symptoms? Do you know of any clinics in the Washington-Baltimore area that take an aggressive approach to treating this type of problem?