migraine w/aura- need and MRI or no?

i am 29 yrs old and had my first migraine ever in Feb and another almost exactly 1 month later in March. Both times with the aura, bright spot in my vision for approx 20-30 minutes, tingling/numbness in finger tips and hands, slurred speech, nausea, then headache comes within an hour and I feel wiped out the rest of the day and the next day. My family and friends of course panicked and pressed me to see a doctor. The doctor didn't seem overly concerned and described it as the migraine w/aura, prescribed a medication to try the next time, and scheduled an MRI. I never go to the doctor or have tests done and am really dreading my $400 insurance deductible. Do you think the MRI is necessary and what would they be looking for?

[cordyceps]

MRI's tend to be a good idea when you have multiple new migraines with aura because of the vascular complications of the aura if nothing else. Your specific symptoms do fit those of a migraine, but it's not uncommon (or at least not uncommon enough not to get it checked out) that severe headaches are symptomatic of something more than just a migraine. I personally have also had the slurred speech/confusion/flashing flights/numbness problem, but I didn't have a headache. As for what they'd be looking for, there are a million different things out there, but none in particular and none that you should worry over. You might consider getting a cardiovascular checkup if you keep getting these attacks and your results at the neurologist all come back clean. :)

[cordyceps]

I meant vascular association with aura**** sorry!

[Dr Santos]

Hi,
How are you? If you have typical migraine symptoms or a family history of migraines, your doctor will likely diagnose this on the basis of your medical history and a physical examination. However, if your headaches are unusual, severe or sudden, additional tests such as MRI may be indicated  to rule out other possible causes for your pain including  tumors, infections and even strokes, aneurysms, neurological diseases and other brain abnormalities. An MRI can also be used to examine the blood vessels that supply the brain. Discuss this with your doctor to ease any anxiety. Take care and do keep us posted.

[abc456789]

thank you both. Of course the day after posting this, I experienced another episode. This time I saw the black zigzag lines which was a first. I immediately took the Maxalt that was prescribed and still had the pain for quite a while afterwards. It subsided about 1.5 hrs later so unsure if it was the medicine or if it just went away on it's own. Around the same time I noticed the medication made me incredibly dizzy. I felt fine lying down but had the spins horribly if I sat up. Now unsure if this is the right medicine for me but willing to give it another try. I know it takes awhile to find what helps you best. The MRI is on Monday so I will mention this to my doctor if they want to see me back after the results.

My brother is 4 years younger and had migraines as a child from ages 7-14 but his were the type with extreme noise & light sensitivity and he would vomit everytime. He still gets headaches on occasion but just seemed to out-grow the migraines one day.

[Dr Santos]

Hi,
Thanks for the update. How are you? Maxalt contains the active ingredient rizatriptan which is indicated to relieve migraine attacks. Possible side effects of this medication include dizziness, sleepiness. feeling weak or fatigued, pins and needles or tingling sensations, flushing, palpitations and even headache. I agree with you that finding the right medicine may take a while and benefits usually outweigh the risks. Take care and do keep us posted with the MRI results. Best regards.