Just had a Complex Migrane

[28yomigranesuff]

I am a 28yo male and last weekend had a Complex Migrane, my headache was mild but my upper right body went numb, speech was incoherent and I was unable to remember names of my wife and family.

The ER treated me initially for a stroke, with TPA, then mediflighted me into Boston for further treatment/test. I had every test I think possible, MRI, EKG, EEG etc and enough blood drawn to supply a blood bank.

I am now going on a week since this incident, and am curious to know about anyones recovery time. I still feel very fatigued and today actually felt very lightheaded and my mind was "cloudy".  If anyone has any thoughts on recovery periods and/or questions to ask when I go back for my consult with the Neuro Clinic at the hospital that would be great.

I am hoping this is a one time occurence but in the event it is not we are taking any and all necessary steps to get this under control.

[28yomigranesuff]

Vaness,

Things seem to have been progressing nicely until last night. In fact I went to the gym for the first time since my episode on the 17th. Last night I felt a bit off, and I think it caused me to be very anxious, something I have never really experienced before. My whole body felt jittery.

Per the doctor on Wednesday I have started Simvastan for High Cholesterol and unsure if that is related. I have had a few short spells of being disoriented/almost lightheaded/dizzy since coming home but feel like they told me that might occur for a while.

But today after waking up I still felt similar to the way I felt last night. I hope I am not growing an anxiety complex over this but need to get my arms around how I should be feeling and what I should be expecting.

I really have not had a headache except on days when I have worn my glasses vs. contacts which are a weaker perscription and I recently ordered new ones. These headaches would be very dull, in between my eyes and usually short lived.

Finally I am going back in a few weeks for a consult, but plan to call the Neuro Clinic tomorrow to discuss these symptoms. Can you let me know what questions I should be asking?

Thanks

[Vanessa Lacuesta]

Hi,

I just need to ask some questions:

Was this the first time you have experienced this?

Were levels of coagulation factors assessed ( PT,aPTT ,INR and fibrinogen?)

Any history of stroke and heart disease in the family?

Any significant events surrounding the onset of your symptoms ( eg strenuous activity, straining, excessive emotions)?

[Vanessa Lacuesta]

Hi,

Just continue to observe your symptoms. Note any progression or worsening of your symptoms. Any new onset of symptoms different from what you have previously noted requires further evaluation.Remember that any weakness or numbness requires immediate consult.

Discuss with your physician the benefits of physical therapy or alternative medicine. Acupuncture and learning relaxation techniques may help. I understand you may be scared and worried. Do not allow the condition to stop you from living a good life.Maintain open communication with your physician. Just avoid travelling alone or driving alone.

Keep us posted regarding your progress.

[28yomigranesuff]

I had my EEG yesterday and am waiting on the results. In the meantime to answer your question. this was my first incident.

However here are a few things I am noticing recently:

At the end of the night I seem to get a dull headache, right now I attribute this to me wearing glasses that are not strong enough (seeing my optometrist on Friday).

Tonight while out I had a moment where I felt lightheaded and a bit off. It lasted only 2 minutes but enough to scare me for a bit.

I am still very tired although today was my best day since coming home. I am hoping this is just a lasting effect of the whole ordeal on me.

My right hand also feels a bit weaker at times, but this is something I am unsure is real or in my mind, (Just thought I would throw this out too)

[28yomigranesuff]

Just read your note. This was the same with me, very frustrating to have such a scary event and no definitive answer. I am now 10 days since it happened and am still very fatigued, and having dull headaches (which I think is due to me wearing my glasses vs contacts which need to be updated to my stronger perscprtion).

I still feel occasionally lightheaded and needing to rest. I have had every test you mentioned above in addition to an EEG as well as being tested for menegitis, and many other diseases. I would like to keep in touch to see what your Dr. vs mine comes up with going fwd.

[Kathy22]

I just had an "episode". Stroke like symptoms- numbing of left hand, arm, corner of left lip, cheek and tongue. Lasted about 1 hour as it traveled. Left arm stayed "heavy" for about 6 hours. Had motor control- but lost sensory during episode. No headache, no auras. Went to ER and tested for stroke with CT, MRI, EKG, Cardio sonogram, carotid artery ultrasound, bloodwork and urinalysis. Stayed overnight at hospital and all test came back negative. Diagnosed as Complex migraine.  I have never had this before, no history of migraines, no residual neurological effects present. I am 38 yo.  I never heard of migraines without actually head pain. Im scared something is no being diagnosed.

[Vanessa Lacuesta]

Hi,

Just to clarify:

Was this the first time that you have experienced this?

As a migraine, these attacks may recur but the frequency do vary from person to person. Migraine is a complex condition and it is easier said than done to tell you to avoid any known triggers. Would you be able to recall any significant trigger that could have caused your complex migraine?

The main issue here is maintaining your quality of life. I suggest you discuss with your physicians the right preventive therapy for you. Ask them how this will affect your lifestyle, your work and relationships. This is a realistic way of tackling this.

I do not want you to worry unnecessarily.Maintain a close follow up with your neurologists and involve your family and friends in your case so they may be aware and thus will understand any changes or modifications that you may set on your lifestyle.Complex migraine with the right management and support from your health providers may be controlled and this should not stop you from living the good life.

[28yomigranesuff]

Thanks for the update, the deficits cleared up within 3hrs or so on the date of the occurence. In addition to numbness and speech issue, I also vomited multiple times in the early stages.

The Neuro Surgeons stated that although I presented like a stroke because of the timeframe from the onset of symptoms to resolution it was more likely the migrane. They stated a stroke comes on out of nowhere, whereas I first noticed the numbness around 2PM and I was able to use my hands. But the issue was as they tried to have me do things I would do something completely different than was asked. For example instead of pulling the doctors hands I would raise mine into the air.

All symptoms seemed to clear up after I feel asleep in the ER for about 2hrs. I was at this time they started the MRI, Catscans etc.

How frequent do these occur for most patients? Is this something I need to worry about day in and out? Or are they generally few and far between?

Thanks for this insight.

[Vanessa Lacuesta]

Hi,

By neurologic deficits , I meant the numbness and incoherent speech. Are they still present?

Complex migraines may be difficult to differeniate from an actual stroke. Usually migraine auras ( the visual symptoms, numbness and speech symptoms ) are reversible and should not last for more than an hour. The auras of more complicated migraines may last more. A seizure disorder needs to be ruled out. Some patients do feel tired and fatigued after an attack.But patients with seizure disorders may present similarly.

About 5-10% of posts in this forum tackle complex migraines.They usually refer to them as basilar, hemiplegic, occipital or ophthalmic migraines.

Keep us posted with regards to your results.

[28yomigranesuff]

Thanks for the follow-up. All tests from the MRI, 3 Catscans and all else have come back negative. I dont know the results of all the bloodwork but I am about 5 days from them taking it and have not heard anything back yet. I have an EEG scheduled for Tues, just to rule out anything else heart wise. I do have high cholesterol which I am now on medication for.

I am not sure what you mean by neurologic defecits but I feel 70% of normal although I am unsure if I am fatigued because of the ordeal (3 days in a hospital thinking I had a stroke) or after effects of this.


Also Saturday morning had a weird feeling and was lightheaded. Is this normal after a complex migrane? In addition what are the frequencey of these with people on this forum in your experience?

[Vanessa Lacuesta]

Hi,

How are your symptoms?

Are the neurologic deficits better? Have they improved?

What were the results of your scans?

What about coagulation disorders ( fibrinogen levels, aPTT,PT, bleeding time) and peripheral vascular disease , were these ruled out?

I commend your proactive approach to this. Will be expecting your answers.