Silent Migraine

[Manubhatt]

In 2001, I suffered an episode with numbness, tingling and pain in the left arm and left cheek. I was admitted to the hospital with a diagnosis of TIA. However, MRI, CATScan, Echo Cardiogram, Caroteid artery scan and all other tests came out normal. I was discharged from the hospital after one week but the symptoms lasted three-four weeks. Since then this must have recurred probably seven-eight times and I was hospitalized three more times each time with the diagnosis of TIA and the same battery of tests that again proved everything was normal. About a month ago, I was again admitted to the hospital with the same initial diagnosis of TIA until a neurologist told me that, in view of my case history and each episode lasting an unusually long period of several days, I probably have Silent Migraine. I have two questions:
1. How do I prove that it is silent migraine?
2. If it is silent migraine, how do I treat it?

[TBird245]

My neurologist told me that I have silent migraines. I'm getting blood work done next week to see if I have migraines and dizziness. I never knew you could tell by blood work. Just thought you might want to ask your doctor if you could get blood work done too.

[marileew]

Hi,

I'm not a doctor or a medical professional... but, I think that you can prove it's a silent migraine by proving it's not TIA.

The way you would prove it's not TIA is if a neurologist was to diagnose you with migraine instead of TIA due to normal scans. Also, I think that it's migraine and not TIA is a really good thing.

Also, you mention that the symptoms lasted for weeks? If a TIA lasts longer than 24 hours, that is a stroke, not a TIA. So, if your symptoms lasted longer then 24 hours and you had originally been diagnosed with a TIA and your symptoms did not resolve prior to the 24 hours that they had started, then that would stop being a TIA and you'd then get diagnosed as having a stroke... and, that would be really quite serious.

So, the fact that your symptoms persisted for so long and you are still alive without emergency treatment for stroke, AND your scans were all normal AND you were diagnosed with migraine after the neurologist saw you... I would say it is very certain that you have silent migraine.

Now, to answer your second question, how do you treat it? You should go back to the neurologist to ask this question, the neurologist will be able to answer this question best. Migraines are treated in many different ways. The usual treatment for migraines are with a medication called triptans, although in your case this may not be the best option as your symptoms are caused by severe temporary brain stem dysfunction (all migraine include temporary brain stem dysfunction but often not to such a degree) and the triptans are counter-indicated often in such cases. I myself have had a few migraines, with headache, that also had stroke-like symptoms accompany the headache and I still take triptans for my migraines, but, that is probably because the vast majority of my migraines are common migraines. That is why I say you would need to discuss with a neurologist what is appropriate for your specific situation. Also, a neurologist might know of an alternative medication other than triptans that would be more appropriate for Silent Migraines.

Migraines of all types are often trigger by events, such as food triggers, physical stress triggers or weather triggers. It would be very useful if you kept a diary of these attacks to record what you ate before the attack as well as if there was a weather change, if your sleep pattern changed recently, if there was any physical stress (such as exercise), etc. That way you may be able to find out what triggers these events and if it is a trigger that is within your control such as a food item or a specific action (exercise, looking at bright lights) then you will be able to avoid these triggers in the future. It is just like how someone with epilepsy will try to avoid looking at flashing lights so that they do not trigger a seizure, you will find what triggers these attacks for you and then avoid those triggers.

Preventative medication may be a solution if you are having these attacks often, although this would have to be a discussion you have with your neurologist.

If you ever experience a new neurological symptom or a new symptom that greatly concerns you that you have not experienced before during one of your silent migraines, return to the hospital as a new neurological symptom could be a sign that what you are experiencing is not one of your normal silent migraines, but could in fact be a TIA or a stroke, and although it feels similar to one of your regular silent migraines, the new neurological symptom will alert you to the fact that what you are experiencing is something different and more serious then usual.