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Complicated Migraine-Differentiall Diagnosis

My 23-year old daughter was recently diagnosed with "confusional"/"complicated" migraine.  (Her physician uses the terms interchangeably.)  She has had 4 "episodes," the first one being approximately 2 weeks ago when she was driving alone, felt a "jolt" to her head (although there was no accident), and found herself waking up in her car on the side of the road approximately 2 hours later.   She had amnesia for the greater part of the day, it seems -- can't remember how she even got back to her apt. or what she did all day, although she believes that she slept a good part of it.    ER in the evening conducted CT Scan, EKG, blood/lab work, and all results were normal.   For the following 5 days, she had continued symptoms of vertigo, was unable to read/drive, poor appetite, and was lethargic, but never a bad headache.  Subsequent to a dr. visit, she had an EEG, which was also normal.  However, meanwhile, she has had 3 additional '"episodes" during which I was with her &, therefore, able to observe.   She becomes suddenly very dizzy (one time, with no warning at all), feeling as though she's going to pass out; sits, kneels or tries to lie down, followed by what seem to be involuntary movements (mildly jerky) of legs, buttocks, back) which she seems unable to control for 20-30+ minutes, after which she suddenly ceases all movement & goes to sleep for 4-5 hours.   During the entire time, she never seemed confused, was able to answer all questions clearly (although with brief responses), but was extremely uncomfortable/miserable with body movements, vertigo, occasional nausea .... no headache before, during, or after, but totally exhausted mentally & physically after the episodes.  

Does this sound typical of "confusional/complicated" migraine?   Are there other diagnostics, i.e. MRI/MRA that we should consider?   ANY OTHER SUGGESTIONS?   THANK YOU SOOOO MUCH!!
~Beth
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WOW!   Thanks for the great advice.... AND the remarkable concern, compassion, and support.   We've had 5 great days in a row, so we'll see how things go, but I'm definitely taking your suggestions into consideration..... THANK YOU THANK YOU THANK YOU!!!!
~Beth
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Hi, my computer locked-up so I could not finish.  Also, does your daughter have any sleep disorders?  I am not a doctor.  But, I do know that complicated migraines can be pretty bad.  I am presuming that she had all the batteries of blood testing profiles including those for infections and of hematological/immune/endocrine functioning among others.  I am wondering if she had MRIs though.  There can be problems that show on a MRI and not a CAT scan.  An MRI is generally a better imaging choice in this case.  There could be white matter lesions that shows on her MRI (that does not show on her CAT scan) and can be indicative of migraines or other deformities, vascular or neurological problems/illnesses.  

Also, it sounds like she is having the seizure-like activity when she is driving, correct?  Do blinking or red lights changing bother her?  What about strobe activity?  Does she ever feel like the cars in traffic are moving when they are not or that she herself is moving when she is not?  These can all be important factors.  Does she get numb or have other visual changes?  Has she had any infections or bad falls or car accidents in the past?  

I know that this is so confusing and can be such a nightmare.  I just wish the best for your daughter because I have suffered many forms of migraines for years and they can seem like they steal your life from you.  Whether seizure, or migraine, or other problem(s) I hope for your whole family's sake (and particularly your daughter's sake) that there are some answers and solutions soon forth-coming.  Please, keep us posted.  We may gain insight that can help others; and mostly of course, we are genuinely interested in your daughter and hopes that she feels better and can get back to a more normal life really soon.  

She is very lucky to have a concerned and caring Mother such as youself.  Try not to let her or yourself get worn down and depressed.  Hurdle each day as it comes.  Take care and God bless.

P.S. There are other more sophisticated types of MRIs such as functional MRIs and Spect/Pet scans.  But, the physicians will have to decide that for you.
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Avatar universal
There are many types of seizures and my guess is that that may be what she is happening.  Yes, migraines can make you feel like you are having a seizure and I have seen people go into seizure-like activity with them and vascular disorders.  I agree with jcverive that more testing is in order and if there are any triggers a medical testing facility where she can be observed and tested under the proper conditions is in order.  There are also some anti-seizure medications that are also used as preventatives for migraines.  What does your daughter take?  Has she had any infections recently or is there any family history of diseases that may relate?  Are there any immune problems in the family?

My other advice is to keep a journal of her symptoms, sleep habits, eating habits (including timing and types of food), timing and dosages of medications, timing of effect of her medications on her, environmental conditions, and other issues such as temperature, her periods, stressors, etc.  It can be a truly enigma to resolve.  Also, sometimes we can have migraines and not feel them as headaches but rather other unusual occurrences in my body.  I have suffered similarly over the past year, but not to this extent.  My best wishes to her.
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Thank you very much for your response..... Just wondering if you have personal experience with this sort of thing... or if you happen to be in the medical field.   I really appreciate your feedback....THANKS SO MUCH!!
~Beth
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These sound much more like seizures to me; the sudden dizziness, uncontrollable muscle spasms, physical and mental exhaustion, and (occasional) amnesia all point to seizure disorders. An EEG with no significant findings is meaningless unless performed at the time of an attack.  If the attacks are frequent enough (or if they can be brought on by a known "trigger"), your daughter probably should be kept in a hospital for observation.  

Until your daughter has an EEG during a seizure, it would still seem more reasonable to treat her as though she has a seizure disorder rather than a migraine variant.

I know that seizure disorders may seem more worrisome than migraines, I'd hate for your daughter to have another attack while driving. She should probably hand her car keys over to a trusted relative or friend until she gets a verifiable diagnosis *and* effective treatment.  Please keep us updated on her condition.
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