Is this a hemiplegic migraine/

[juleslady]

For many years I suffered from occasional migraine headaches usually light sensitive, I have only ever had the flickering at the corner of my eye 3 times and on none of these occasions was it because of or at the onset of a migraine. I did begin to notice I would often jumble words before the onset of a migraine headace. About a month after a car accident which left me with whiplash in 2002 I had a strange tingling in my right thumb which, over the course of a few weeks, travelled up my arm to my elbow slowly turning from tingles into numbness. I was told it was all in my head, then told it was carpal tunnel, then later a trapped nerve and was given celebrex. I had physio which didnt help as my hand began to start feeling weak and ecg was normal. I then had a disturbing visual defect  where there was a certain lack of color and focus in one eye. An eye test confirmed this and I was told I had a cold in my eye. My hand and arm were still numb a few months later and I went to see one of the top neuro surgeons, another ecg, and i was told I had Thoracic outlet syndrome but it wasnt bad enough to be operated on. I lost my job and lived with it till it calmed down after about 7 months but my hand was still weak and didnt feel right. Over the next few years the tingling and numbness came and went. One day during a particularly bad incident my arm went numb, my ribcage went tight and my feet and legs were tingling/numb I went to the hospital, another ecg and xrays, they couldnt tell me what was wrong I was sent home with ibuprofen and flexeril. Eventually it passed. About a year after this I was working at a bank when my right arm again started to go numb but this time it became so bad I couldnt even hold a pen and I had to write with my left hand. Finally after being pressured by manager I went to see more doctors another ECG, mri's, xrays etc. This time during an mri the dr saw little flashes of light in my brain which he said was a migraine and the cause of it. After about 3 or 4 months the hand returned to "normal" it still did not feel 100% but at least I could type and hold a pen again. Then about 6 months later my other hand went "funny" again lasting 3 or 4 months but alot milder than the right handed episodes. On this occasion though I had the feeling of a mild "brainfreeze" for several days on my right side before it happened. When I again had the brainfreeze feeling 4 months ago I knew what was coming. Sure enough but this time its in both hands the right one is slightly worse and I have an intermittant brainfreeze/pain in my left eye socket I may not have pain for several days then have it constantly for two or three or just for a few hours if the medicine works?. On the top of my skull there are spots which when pressed feel like they are bruised but they change position or some days there may be none. I am typing this with 2 fingers, the last three on each hand feel numb, and are hard to control, but stiff and the numbness goes up to just past my wrist on the left hand and my elbow on the right. When I try to cup my hands the last 3 fingers go off at an angle or curl up, when i touch my thumb to each finger I usually miss the pinkie even when I am looking right at it! My family decided I was bipolar so I went back to the free hospital who gave me esgic/Fioricet but doesnt do much for the pain and seems to have given me diarrhea and made my fingers go much stiffer since i started taking it. As for the bipolar the dr seemed to just skip over that. Yes I do get depressed and moody mainly because I often have a headache and CANT USE MY HANDS NORMALLY DURRRR! I have read alot of stuff about hemiplegic migraines but it was never said to me by the neurosurgeon that I had this.. he only said migraine and I dont seem to have a lot of the stuff listed as symptoms of these. Yes I do feel nausea - but it might be the medicine.. yes occasionally i will notice spots in front of my eyes like little commas doing loopty loops for maybe a second then they are gone but its very rare I have had it maybe twice in the last 4 months. Yes I am uncoordinated but I always have been, yes I am confused! Most of the sites I have read the paralysis should only last a few days not months!! and is this even classed as paralysis they arent hanging limply by my sides but they sure are not fully functioning.

[juleslady]

I will post once i have the spinal tap, but i have no ins. so i have to wait for an appt with lsu.

[Dr Santos]

Hi,
Thanks for the updates. During a neurological examination or an exam of the functioning of the brain and spinal cord,  deep tendon reflex and muscle strength are  done. This link from the national institutes of health may be helpful: http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=cm&part=A2361
Diagnosis of MS is based on medical history, neurological exam and  a variety of specialized procedures such as MRI. Abnormal spots on the brain MRI can be caused by other conditions such as those found in elderly people or people with migraine headaches or high blood pressure. Take care always.

[juleslady]

the little floating lights in the mri, :)

[juleslady]

ty for your response, further studies now have the dr.s at lsu thinking its MS, I had a reflex exam and the Dr said I had no reflex in my elbow and graded it a 2, while the other was a little better and graded 1. Do you know what type of test this is and where I can find a chart for the grading system. The little floating lights one neurologist (the top in his field - arent they all) said were migraines may actually be a telltale sign of ms :(

[Dr Santos]

Hi,
How are you? I'm sorry to hear what you've been through for the past months. Hemiplegic migraine is a very rare but well described form of migraine.  It was initially described as a type of migraine consisting of recurrent headaches associated with temporary unilateral hemiparesis or hemiplegia. Sometimes, this is accompanied by ipsilateral numbness or tingling, with or without a speech disturbance. The neurologic deficit is transient and usually clears in minutes to hours, or resolves with the beginning of the headache phase. Diagnosis is usually confirmed with repeated reversible episodes. If paralysis occurs more than a month, you may need to have this evaluated further by a neurologist. Differential diagnosis includes focal seizures with postictal paralysis, mitochondrial cytopathies, intracranial hemorrhage, mass, infection, or cerebral infarction. Hang on and be proactive about finding the underlying cause.  Take care and do keep us posted. Warm regards.