Loss of Speech After Complicated Migraine

[illini89]

On Thursday I was arriving to work and my right side of my neck down through my arm started hurting really bad, I looked in the mirror and the right side of my mouth was drooping.  I could still communicate so I called my cardiologist.  They sent me to the E.R..  Within 30 minutes I could not move my right side, speak, move my head to the right, or my eyes to the right.  I was 30 minutes from getting the blood thinner Stroke patients get and then my head started throbbing.  My arm started moving.  Over the next few hours I could slowly move my arm, and leg.  My face slowly came back to normal.  I am in day 2 and I have not regained my speech.  I have been diagnosed with a complicated Migraine.  I have also had a suspected TIA previously.  I some tests on Friday and during recovery  I could speak briefly after being sedated, but I don't remember anything.  Can anyone help me understand what is going on with my body. Why I can speak when I am sedated?  I am really frightened.  I am only 39 and feel like my body is giving out.  My mind knows what I want to say but my mouth won't form the words.  

[Dr Santos]

Hi,
I'm sorry to hear about the conflict with your neurologist. Indeed, a referral to a psychiatrist is not indicated and may not be the solution to the problem. Like diagnosis of migraine variants, diagnosis of Multiple sclerosis is also done by ruling out other conditions. It can be difficult also since it also mimics other nervous system disorders. A complete neurological examiantion is important and it may show reduced nerve function in one area of the body, abnormal nerve reflexes, decreased ability to move a part of the body or decreased or abnormal sensation. Lumbar puncture, including CSF oligoclonal banding, may indeed help with the diagnosis. However, you can also ask another doctor's opinion prior to the spinal tap to help ease any anxiety. You can also check out the MS forum ( http://www.medhelp.org/forums/Multiple-Sclerosis/show/41) to help with your decision. Take care and hope to hear from you soon.

[illini89]

I have since had an additional episode.  My MRI still only shows the two gray matter in the upper forum of the brain.  With all my research I truly believe that a spinal tap needs to be done to rule out MS. However, because I have pushed back against my neurologist as well as asked for a second opinion he is requiring me to have a psychiatric evaluation.  Not only am I humiliated, stunned, but it is continuing to delay my retreiving the  cause of what is going on.  I am so angry and frustrated.  After review all of my medical files, I realized that no one had performed any comprehensive blood work up.  I informed my neurologist and is quote was "I don't do blood work"  Therefore I had to make another appointment back with my internal medecine doctor and she completed the blood work.  She became so frustrated that she personally called the neurologist and stated that I did not need to see a psychiatrist and she felt that a spinal tap was a reasonable request.   I told my neurologist that if I did not have any symptomatic issues proven from the Spinal the Tap he could hand a sign in the front of his office saying he was right and I was wrong.  My internal medicine doctor is willing to send me to a MS clinic but it seems so useless if the spinal tap shows I do not have MS.  Only 5% of the MS population show no lesions in their brain and still have MS.  I have two Gray Plaque Matter in brain with no fingers surrounding the cortex of my brain.  All I am asking is to prove that I am not in that 5% before I continue down the complicate migraine route because my episodes are occurring at least 1 every 2-3 weeks.  Any ideas????

[Dr Santos]

Hi,
Thanks for the updates. It is good that the TEE was normal. Were you able to see your neurologist? Continue your medications and inform your attending physician if there are no improvement with the symptoms. If diagnosis of stroke or TIA was made, additional diagnostics may need to be done. I understand how it is, of not knowing the cause, however, identifying the underlying cause and understanding it will greatly help.  Take care and hope to hear from you soon.

[fuzziedhead]

I am so sorry. It looks to me like maybe you had a stroke after all?
have you had a MRI done, one with contrast and one without?

[illini89]

My TEE came back with no PFO ( I was very depressed about that).  I still have difficulty speaking but it is better.  I have the strong spasms that jerk my head to the left side before I can speak.  The latest MRI shows I have a oxygen defeciency getting to the right side of the brain.  Now they have me so doped up on clonazepam, 200 mg of Topamax, Lexapro to stop the spasming and the splurring of the speech, but I don't speak becasue I am a zombie.  I am scheduled to meet with a specialist at Duke university on July 11th but at this point I feel like I am going in sane.  Every morning when I wake up I don't want to open mouth in fear that I still cant speak then I just cry.  My kids are so sad hearing me this way.  I only have 50 percent usage of my right arm.  I sometimes I get so confused I cant tell you my right from my left.  Most of the time I just into my bathroom and cry. My right leg feels like it is asleep all the time and my right knee just throbs..  Sure wish I could trade this body in for a new one.  This worst part about it.  Is I was a very successfuly business owner.  I spoke at several functions, wrote articles, was a mentor for new women owned businesses, was politically involved, I just one owner of the year last year.  Now I just hide at home and make up stories on why I can't come into the office.

[Dr Santos]

Hi,
How are you? What other diagnostic tests were done? Diagnosis of rare types of migraine variants such as complicated, basilar or vestibular  migraines  are only given when other conditions including blood and cardiac disorders have been ruled out.These types of migraines have been associated with vascular spasms at the base of the brain which may explain the reversible symptoms of slurring of speech, visual problems and weakness in the extremities. Hang on and be strong. Do keep us posted with tomorrow's procedure and cardiologist follow-up. Take care and best regards.

[illini89]

Yes, I am going on my third day.  The Doctors keep on telling me to be patient that it could take upt to 3-5 days with the severity of the migraine I had.  I have a procedure tomorrow to check my heart for a PFO so hopefully the cardiologist will have more answers.  My speech is coming back in spurts.  I can yell out certain words after struggling so I am sure it will come back.  I am just really scared.  

[fuzziedhead]

oh sorry - I might have misunderstood - do you mean it's been TWO days since
that migraine pain episode which have passed by then, and you still can't speak normally?

[fuzziedhead]

don't be frightened, it's normal with complicated migraine.
google Serene Branson -she has the type of migraine you have.
nevertheless, get yourself checked thoroughly. if you want more info, PM me :)

Fuzzy