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Neurology (Expert Forum)
Could symptoms be due to migraine even if I have them w/out a headache?
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Could symptoms be due to migraine even if I have them w/out a headache?
by gromit12, Jan 21, 2007 12:00AM
I have been having unexplained symptoms for 6 mos. I’m 43 female don’t smoke/drink. Several tests done all negative (MRI, spinal MRI, EEG, visual evoked potentials, overnight sleep study, multiple sleep latency test, blood tests). MS, sleep apnea, narcolepsy, myasthenia gravis, b12 deficiency, thyroid, seizures all ruled out. I have had depression & some anxiety. Took antidepressants March 05-June 06 (Zoloft 50mg, then Celexa 10mg, then Lexapro 5mg) but stopped taking them due to side effects (constant drowsy sleepy groggy sedated feeling). Symptoms began when I was on antidepressants but didn’t go away when I stopped. I take Maxalt 10mg for migraines. Have had migraines since childhood. My migraines have gotten worse & now lasting 2 or 3 days, used to go away after good night’s sleep. Consist of a painful throbbing on the right side of my head behind my eye. Wake up several times a night. I vomit & am sensitive to sudden movement, light, smells, sound. Now have to take more Maxalt (usually 4) & sometimes it’ll take the edge off but the headache doesn’t go away until it runs its course. Get them once or twice a month usually a few days before my period. My symptoms: Motor problems-a general clumsiness that fluctuates but doesn’t come on suddenly. I notice it more often when I am tired or in a hurry. Drop things, can’t get a good grip, things slip through my fingers. It’s like my hands have a mind of their own, there is some kind of disconnect. Don’t feel pins & needles, numbness, tingling. Sometimes slur speech, drool, & stumble (these have improved since symptoms began). Cognitive functioning-memory problems, confusion, problems concentrating, trouble coming up with the right words, trouble organizing my thoughts, staying focused in meetings, social situations, conversations. Memory problems have come on rapidly. Increased sleepiness & fatigue-have a hard time getting things done like I used to, come home from work exhausted, sometimes have trouble staying awake, have a hard time waking up. Could my symptoms be due to migraine even if I have them when I don’t have a headache?
Doctor's Answer
by CCF-Neuro-M.D.-SH, Feb 11, 2007 12:00AM
First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes.
The symptoms and story you provide are most likely related to refractory depression and difficult to control migraine headaches. Depression is known to cause the side effects that you describe of loss of focus, memory problems, confusion and fatigue. The 'disconnected feeling' is classic for depression. That being said, there are certain 'auras' of migraine headaches that can present with confusional spells, and they are often associated with fatigue. The antidepressants that you mentioned are of the 'more sedating' variety. Some of the antidepressant that might be 'more activating' for you are prozac, wellbutrin and effexor. The headaches that you describe are typical migraines. It is also common that migraines come around the time of your period. With 1-2 migraines per month, with headaches appearing at a typical time-one option is called 'mini-prophylaxis'. This involves taking a long acting triptan (such as Frova or Amerge) 1-2 times per day for the 4-5 day time block around the time of your period when you headache is likely to occur (Frova has a pre-packaged mini-prophylaxis pack). Confusional spells and memory problems related to migraines is more rare (than with depression) but do occur. If the mini-prophylaxis strategy is not successful then a daily prophylaxis medication such as elavil, topamax, nadolol etc. would be indicated.
I hope this has been helpful.
The symptoms and story you provide are most likely related to refractory depression and difficult to control migraine headaches. Depression is known to cause the side effects that you describe of loss of focus, memory problems, confusion and fatigue. The 'disconnected feeling' is classic for depression. That being said, there are certain 'auras' of migraine headaches that can present with confusional spells, and they are often associated with fatigue. The antidepressants that you mentioned are of the 'more sedating' variety. Some of the antidepressant that might be 'more activating' for you are prozac, wellbutrin and effexor. The headaches that you describe are typical migraines. It is also common that migraines come around the time of your period. With 1-2 migraines per month, with headaches appearing at a typical time-one option is called 'mini-prophylaxis'. This involves taking a long acting triptan (such as Frova or Amerge) 1-2 times per day for the 4-5 day time block around the time of your period when you headache is likely to occur (Frova has a pre-packaged mini-prophylaxis pack). Confusional spells and memory problems related to migraines is more rare (than with depression) but do occur. If the mini-prophylaxis strategy is not successful then a daily prophylaxis medication such as elavil, topamax, nadolol etc. would be indicated.
I hope this has been helpful.
I am a 28 year old male that has been having around the same feelings that everyone has been discribing. It all started a little over a year ago, with a bloody nose on my wedding night. Then it went to me feeling light headed and numb with a cold sweat thoughout my body. That went away for a few days then I came down with this pressure in the top part of my head that slowly worked its way down to the front of my forhead. A lot of off balance feelings, like I was on a boat or rocking back and forth. So I went to the hospital and had a cat scan done. They found nothing. I went to my dr. and told him I thought it was a tumor or something bad. He said not to worry and that if I continued to have these feelings that he would send me to have a MRI done. Which in turn I had done, they found nothing. I was sent to see a Neourolgist and he looked over my MRI and said no tumors or signs of stroke nor Clots or anything like that. So he sent me to have this test done called an MRV, which is almost the same as an MRI. THat also came back negative for nothing. ALl my symtoms had seemed to disappear around this time also, but within the last month or so I've started getting this pressure again in the top part of my head that moves down into my forehead and behind my eyes. Almost like a burning feeling sometimes, or like I've got a sharp ***** in the cornor of my eye. Almost like my brain is bleeding. Sometimes I have feelings in my head like I have little bubbles moving and popping in my head. Also sometimes I feel like someone has stuck their fingers in my brain and split my brain into two pieces. I'm scared of what it is cause no doctor can pin point anything except stress or tension headaches. Gave me medication that does not help. Can you always have tenision like that that lasts for days and goes away for weeks at a time? I've had no loss of vision or fainting or anything of that sort. Please help!