Diagnosed with migraine after initial dx of TIA

[dkdean]

I had originally posted in the MS forum due to the drs saying I could be in the early stages of MS, but I have now beem diagnosed with a migraine (no headache--aura for 3 weeks).  
Hello :-)  I've been doing lots of research this last week and this site seems to be a wealth of knowledge.  My story--An overall healthy 32 y/o female.  Last Monday as I was responding to an email, I started with bright halos/aura in my eyes, very bright--I then realized I could not read what I had just typed and could not figure out what words I wanted to type next.  My right hand then went numb and the numbness travelled up my right arm and into my face/cheek/teeth/tongue.  I continued to get more confused with my speech and struggled to communicate.  From visual disturbances to numbness being essentially gone, it was about 45min.  I was driven to the ER and went through a variety of tests--CT, echo,  u/s of neck/carotid, MRI.  Was told that the MRI was fine and that they felt I had suffered a TIA (mini-stroke).  I have continued to have some vision issues and numbness in my pinkie and right forearm.  When I called on Wednesday to get the bloodwork results, I was told that in subsequent reads of the MRI, 'non-specific lesions' in the left frontal and temporal lobes were noted on the MRI and 'demyelination could not be ruled out'.  I have an appt with a Neuro-Optha  in 2 weeks and met with the reg neuro in yesterday.  The radiologists are suggesting another MRI with and without contrast to take a better look at the lesions.

Here's the info from yesterday's appt.
So, the 'diagnosis' from the appt today was that I am having a migraine (silent--no headache).  Some key points:
1-where my lesions are wouldn't be causing the types of symptoms I am currently experiencing
2-MS symptoms are typically sudden--ie. no numbing, then not, then numb again--it is and stays that way for 2+weeks
3-TIA symptoms go away within 24 hours--completely--no continuing effects--therefore, I did not have a TIA.
4-Continued symptoms could mean a true stroke w/damage, but my MRI doesn't show a stroke.
5-arterial migraines can cause all of my symptoms...since they are within the brain and not on the surface, they do not cause headache pain, but can cause confusion, loss of speech, numbness, halo/aura/visual problems for some time. Sometimes they start with one symptom and move into others; mine is odd in that it's been 2-3 weeks of symptoms--kinda like a bell curve--vision stuff, the event, more vision and residual numbness
6-MRI with/without contrast in 6 months to compare
7-Starting on Amitriptyline (Elavil) at night--it's an anti-depressent that is approved to treat migraines. It is intended to be a proactive approach--so, taken daily. Can cause sleepiness, so I take it at bedtime. We will see how I feel in two weeks, then up the dose if I am not feeling better--continue to up for a few weeks (if needed)--then change meds....if those don't work then we will look at other causes.
Still trying to wrap my mind around a migraine without a headache that can cause my symptoms, but certainly hoping we're on the right track.

?? Do others experience migraines that present like this?  6 days of aura, loss of vision/bright lights/travelling numbness of one side, continued aura/visual disturbances.  I am going on 3 weeks of visual disturbances now....Is that common???  

I'm trying to get as much info as I can to keep myself prepared...I realize there isn't much I can do to change what is going on, but I feel better getting all the research done that I can!

Any insight???
Thanks,
K

[whatuask]

I've had these things for 14 yrs now, & this is the first time i've ever gotten involved w/ a forum!

my story is similar, but for sure more severe. there must be a genetic component, b/c my mom (i'm 35) has been able to guide me through it since she had the same thing. she hasn't had one (i think) since menopause, so we believe there's a hormone component.

lots of things to say that seem like might help others, so here goes!

i had my 1st one after being on the birth control pill for just under a year. sounds just like many stories: going numb on 1 side, but i completely could not communicate, talk, write, my vision went weird, hearing in & out-i woke up in the hospital cuz i blacked out completely. i literally thought i had gone crazy. the ER doc told me (i was only 21 & very naive!) it was a TIA brought on by the BC pill & to never go on it again, that some women couldn't handle the hormones.
we moved from CO (high altitude & 300 days of sun) to Chicago (not much sun & sea level), & for 8-9 yrs, i didn't have a single one. as soon as we moved back to CO, I had maybe 3 within a couple months, & a few more within our 3 yrs there.

mine were so bad a couple put me in the ER b/c i couldn't function & people around me didn't know what to do!
i also had never had headaches, but boy did i get a rude awakening!
mine slowly (maybe several minutes) went from tingly numbing face, hands, arms (usually 1 side, sometimes both) to worse & worse confusion, always losing my ability to communicate, read, write-anything. my husband has gotten used to it, keeping my kids away b/c i get really confused easily, then i cry b/c it's scary.
anyway, if i took a Maxalt right away, it would keep the headache at bay, then i'd need a solid 12 hrs to sleep, & i'd be pretty normal the next day-maybe just a bit tired.

they varied in severity. then we moved 2008 to China (sea level, completely different climate). i didn't have one the 1st year; i had a mild one the 2nd year, & i just had maybe my worst ever 2 wks ago. i had been convinced it was the altitude, sun, maybe dehydration. but not so apparently!
here's a theory: 3 mos. ago I had a D+C for a year's worth of irregular bleeding. it could very well be the whole hormone theory wreaking havoc on my body. who knows.
but this aura was so bad that it made me more depressed than ever (thinking thoughts like "what if this is related to alzheimers & dementia like my grama? what if i lose my mental acuity more & more from this?" i've heard we suffer slight brain damage from these!). in the last couple years i have just felt like my mind is slipping, i'm not as quick as i used to be-not getting younger, right:)
importantly, the Maxalt simply didn't work this time. i had maybe the worst headache EVER-i was writhing in pain. i have the utmost sympathy now for sufferers. i was also confused from the moment i woke 7am for maybe 8-10hrs, but still slow for days after. yes, i need help. i don't have the medical care till summer, but will for sure get it!
i am now working part time, so it's not necessarily stress, although i do have 1.5 special needs kids (1 pretty needy, the other not as much)
hand tingling & overall cloudiness of mental state has become normal almost daily occurances, but i notice less if i'm active & outdoors.  
i just have to acknowledge that at least i'm at peace about it b/c of strong faith. God will take care of me & lead me to the right doctors & medication & won't give me more than i can handle. look to Him, the Great Physician...
-fellow sufferer

[Dr Santos]

How are you? You are right in being hopeful about this. Being proactive is the better in a lot of aspects. You can also try complementary and alternative medicine such as biofeedback and other relaxation techniques that have been effective to many migraine sufferers. Hang on and do keep us posted. Take care always.

[dkdean]

Hard to tell on the Elavil right now...I haven't had noticeable numbness the last day or two.  The vision is still off....I thought maybe it was starting to improve yesterday, but it's hard to tell right now since it's been off for a few weeks.  I think I am forgetting what my normal vision feels like!  Still hopeful that this will be what works, but looking into other aspects as well.  THanks again!

[Dr Santos]

Hi,
These phases occur differently from one person to another. One good thing is that even with out headache, you can still respond to the same migraine medications. How about the antidepressant? Is there any relief?

[dkdean]

Thanks for the response.  I never had the potential phases...at least I don't think so.  I need to see how long the pro/post-drome pieces typically last.  3 weeks seems like a lot to me, but maybe it's not?

[Dr Santos]

Hi,
How are you? I agree with your doctors that you should seek consult with a neuro-optha to rule out eye pathology and to repeat the MRI to confirm the presence of these lesions. Acephalgic Migraine or silent migraine refers to a migraine attack without a headache. During a migraine attack, there are four potential phases: prodrome, aura, headache and postdrome. Not all patients with migraine experience all four phases. It can skip the headache phase, hence acephalgic migraine. Do keep us posted. Take care and best regards.