Aa
Rolling Migraines with dizziness, neck pain, and aphasia lasting longer than one week
I am a 32 yoa female with a history of migraines beginning at approximately 24yoa. I have experienced what seems to be two types of migraines. The first and most common migraine I have is always preceeded almost immediately by an aura of small sparkly floaters in my field of vision. Those particular migraines are typically manageable with otc migraine meds if I take it during the aura stage. Those migraines do not concern me terribly as I am still able to function if I take medicine soon enough.
The second type of migraine (though I'm not 100% certain it is a migraine, I'll call it that for lack of a better term) is much more frightening and the main topic of my question. Typically I will wake up with these migraines. I have only been awake a handful of times when this type of headache begins and will attempt to explain it adequately.
On Thursday (one week ago yesterday) I woke in the very early morning feeling odd, disoriented. I wasn't sure what was happening but had the thought it felt a bit like the early stages of a normal migraine. I took some advil migraine and went back to bed. I was able to go back to sleep and woke two hours later to get ready for work. As I was getting ready for work I experienced the sharply focused vision. I then lost my fine motor skills. My husband had to help me get dressed. I should have at that time called in sick but hoping the medicine would work, I did not. I drove to work wearing my sunglasses because the headlights and street lights made my head spin. When I got to work, my motor skills further regressed. I was unable to unlock a cabinet, write my name, or pick up the pen that I dropped. At that point I lost the ability to speak fluently. Words would not come out right and I found that I could not think of the names of things that I knew. I then lost my peripheral vision followed shortly by a whirling pinwheel effect in my frontal vision. My coworker became alarmed as I started to stumble and had to lean against the door to keep from falling. She wanted to call EMS but I refused ('no' being the only word I could say to refuse). She instead called my husband to come and get me. By the time he arrived, the only thing I wanted in the world was for my head to stop hurting. The pain was easily and by far the most intense I have ever experienced in a migraine. He took me home and put me to bed but I was unable to fall asleep. My mind would not shut off. I had random thoughts flying through my brain. I cannot even recall what I was thinking just that there were so many thoughts and images screaming through my head that it felt full. The images particularly, and I do not recall any image specifically, moved so quickly they made me ill. I felt I was falling off the middle of my bed and that my brain was swimming. When my husband came home from work that evening, I was still having difficulty with my speech and vision. He took me to immediate care where the dr on call sent me to the ER. The ER staff evaluated me and decided to treat the pain and nausea and to monitor me for a while. They pushed anti-nausea meds and dilaudid twice. The next day, I felt that the headache was still there, just sleeping. I stayed home from work that day and slept as long as the medication would let me. I woke up feeling slightly better but when I got out of bed the dizziness and nausea hit me hard. Saturday I woke up feeling slightly better in that I had no head pain. I was still slightly dizzy and nauseous and my speech was still broken and slow. I went to work to help with a big project. I was again sent 'home' as by noon my speech had become difficult for the others to understand. I work very closely with some paramedics that I consider friends. They were alarmed and proceeded to check me for stroke markers. My BP, which is normally in the 120/70 range was checked at 183/108. They sent me to the hospital as a possible stroke. The ER team evaluated me and decided to keep me overnight for observation. While there they conducted a ct scan on me. The scan came back normal and an MRI was ordered. I was dismissed from the hospital the next morning and told to take excedrin or advil if my head ache returned. My speech at the time of dismissal was still slow and deliberate but somewhat improved. Several hours after I left the hospital, my headache returned again with the nausea and dizziness. By Monday afternoon the pain, dizziness, and nausea were again at a debilitating level. My Dr was unable to see me that day. On Tuesday, with no abatement of my symptoms, I was able to see my Dr. She was alarmed by my symptoms and wanted me to go back to the ER. I refused, tired of being sent there to be pumped full of meds and sent back home to 'Sleep it off'. My Dr called on Thursday and told me the MRI and MRA came back normal and that the only abnormality with my bloodwork was a slightly elevated white blood count. She referred me to a neurologist who will be unable to see me until Nov 16. I will be off work until that time. I have been constantly dizzy and nauseous for the last four days. My speech has been gradually improving but again still requires deliberate thought and is painfully slow. My thought process has seemed to clear quite a bit and in my mind I can speak quite normally. That is to say my thought process does not seem impaired and I often feel that when I speak I am going to open my mouth and it will all come out right, though it does not.
I do not know if it is important or not, but I should mention that my neck is very stiff. My dizziness increases violently if I move my head too quickly or if I tilt my head back. There is a small area sort of in the middle of the right back of my neck almost at the base of my skull that is tender to manipulation. Also, I have constant ringing in both of my ears. The pitch is occasionally different in each ear but always there. I feel as if my head is bobbing all the time whether it is moving or not and frequently I feel as if it is just very heavy or there is an intense amount of pressure as though my skull is too small for my brain.
I have had some changes in medication within the last two weeks. Almost two weeks ago I had a mirena IUD removed as it was expired and not in its proper place. It was replaced one week later with a nuvaring which I discontinued two days later. The nuvaring made me feel out of control and very moody. The day after it was removed is the day I woke with the headache. I am also on Phentermine 37.5 once daily. I have been on Phentermine for about three months now with no negative side effects. Recently I was discovered to be vitamin D deficient. I was given 50000 iu weekly Vitamin D supplement therapy. The Dr prescribing the Vitamin D left the practice during the course of my treatment and my prescription ran out. It has not been revisited by my current Dr, though I did bring it to her attention.
I am left feeling a bit crazy to be honest, though I know I am not imagining these things. The remaining issues are of great concern to me. I cannot do my job if I am dizzy and cannot speak (to be fair, my speech is still improving daily but it is still NOT what it should be). I could deal with the headache as it has become more of a constant dull ache. The tension and almost burning sensation in my neck is somewhat of an issue as well because it seems as if the worse my neck feels, the dizzier I am. The dizzier I am the harder it becomes for me to focus on speech and to speak clearly. I am not convinced that this is all the result of a very bad migraine. It seems too long for these issues to persist. Do you have any ideas at all that I might be able to ask the neurologist about. I cannot function this way and I am not the type to sit back and do nothing while waiting to be fixed.
Thank you in advance for any insights you may be able to offer.
Amy
The second type of migraine (though I'm not 100% certain it is a migraine, I'll call it that for lack of a better term) is much more frightening and the main topic of my question. Typically I will wake up with these migraines. I have only been awake a handful of times when this type of headache begins and will attempt to explain it adequately.
On Thursday (one week ago yesterday) I woke in the very early morning feeling odd, disoriented. I wasn't sure what was happening but had the thought it felt a bit like the early stages of a normal migraine. I took some advil migraine and went back to bed. I was able to go back to sleep and woke two hours later to get ready for work. As I was getting ready for work I experienced the sharply focused vision. I then lost my fine motor skills. My husband had to help me get dressed. I should have at that time called in sick but hoping the medicine would work, I did not. I drove to work wearing my sunglasses because the headlights and street lights made my head spin. When I got to work, my motor skills further regressed. I was unable to unlock a cabinet, write my name, or pick up the pen that I dropped. At that point I lost the ability to speak fluently. Words would not come out right and I found that I could not think of the names of things that I knew. I then lost my peripheral vision followed shortly by a whirling pinwheel effect in my frontal vision. My coworker became alarmed as I started to stumble and had to lean against the door to keep from falling. She wanted to call EMS but I refused ('no' being the only word I could say to refuse). She instead called my husband to come and get me. By the time he arrived, the only thing I wanted in the world was for my head to stop hurting. The pain was easily and by far the most intense I have ever experienced in a migraine. He took me home and put me to bed but I was unable to fall asleep. My mind would not shut off. I had random thoughts flying through my brain. I cannot even recall what I was thinking just that there were so many thoughts and images screaming through my head that it felt full. The images particularly, and I do not recall any image specifically, moved so quickly they made me ill. I felt I was falling off the middle of my bed and that my brain was swimming. When my husband came home from work that evening, I was still having difficulty with my speech and vision. He took me to immediate care where the dr on call sent me to the ER. The ER staff evaluated me and decided to treat the pain and nausea and to monitor me for a while. They pushed anti-nausea meds and dilaudid twice. The next day, I felt that the headache was still there, just sleeping. I stayed home from work that day and slept as long as the medication would let me. I woke up feeling slightly better but when I got out of bed the dizziness and nausea hit me hard. Saturday I woke up feeling slightly better in that I had no head pain. I was still slightly dizzy and nauseous and my speech was still broken and slow. I went to work to help with a big project. I was again sent 'home' as by noon my speech had become difficult for the others to understand. I work very closely with some paramedics that I consider friends. They were alarmed and proceeded to check me for stroke markers. My BP, which is normally in the 120/70 range was checked at 183/108. They sent me to the hospital as a possible stroke. The ER team evaluated me and decided to keep me overnight for observation. While there they conducted a ct scan on me. The scan came back normal and an MRI was ordered. I was dismissed from the hospital the next morning and told to take excedrin or advil if my head ache returned. My speech at the time of dismissal was still slow and deliberate but somewhat improved. Several hours after I left the hospital, my headache returned again with the nausea and dizziness. By Monday afternoon the pain, dizziness, and nausea were again at a debilitating level. My Dr was unable to see me that day. On Tuesday, with no abatement of my symptoms, I was able to see my Dr. She was alarmed by my symptoms and wanted me to go back to the ER. I refused, tired of being sent there to be pumped full of meds and sent back home to 'Sleep it off'. My Dr called on Thursday and told me the MRI and MRA came back normal and that the only abnormality with my bloodwork was a slightly elevated white blood count. She referred me to a neurologist who will be unable to see me until Nov 16. I will be off work until that time. I have been constantly dizzy and nauseous for the last four days. My speech has been gradually improving but again still requires deliberate thought and is painfully slow. My thought process has seemed to clear quite a bit and in my mind I can speak quite normally. That is to say my thought process does not seem impaired and I often feel that when I speak I am going to open my mouth and it will all come out right, though it does not.
I do not know if it is important or not, but I should mention that my neck is very stiff. My dizziness increases violently if I move my head too quickly or if I tilt my head back. There is a small area sort of in the middle of the right back of my neck almost at the base of my skull that is tender to manipulation. Also, I have constant ringing in both of my ears. The pitch is occasionally different in each ear but always there. I feel as if my head is bobbing all the time whether it is moving or not and frequently I feel as if it is just very heavy or there is an intense amount of pressure as though my skull is too small for my brain.
I have had some changes in medication within the last two weeks. Almost two weeks ago I had a mirena IUD removed as it was expired and not in its proper place. It was replaced one week later with a nuvaring which I discontinued two days later. The nuvaring made me feel out of control and very moody. The day after it was removed is the day I woke with the headache. I am also on Phentermine 37.5 once daily. I have been on Phentermine for about three months now with no negative side effects. Recently I was discovered to be vitamin D deficient. I was given 50000 iu weekly Vitamin D supplement therapy. The Dr prescribing the Vitamin D left the practice during the course of my treatment and my prescription ran out. It has not been revisited by my current Dr, though I did bring it to her attention.
I am left feeling a bit crazy to be honest, though I know I am not imagining these things. The remaining issues are of great concern to me. I cannot do my job if I am dizzy and cannot speak (to be fair, my speech is still improving daily but it is still NOT what it should be). I could deal with the headache as it has become more of a constant dull ache. The tension and almost burning sensation in my neck is somewhat of an issue as well because it seems as if the worse my neck feels, the dizzier I am. The dizzier I am the harder it becomes for me to focus on speech and to speak clearly. I am not convinced that this is all the result of a very bad migraine. It seems too long for these issues to persist. Do you have any ideas at all that I might be able to ask the neurologist about. I cannot function this way and I am not the type to sit back and do nothing while waiting to be fixed.
Thank you in advance for any insights you may be able to offer.
Amy
I forgot to mention, I was just diagnosed as Vitamin D deficient to the point they a give me prescription and OTC doses.
I have had similar experience. I woke up one day and was dizzy 24/7 with no movement at all. I was falling continually and some sagging on one side of face. I was similar to what I believe having alzheimer's would be. I could not remember things I clearly knew, I forgot words/people, couldn't find things a minute after setting them down and got very agitated. The doctors were looking at reactions my medications (Phentermine), thought I had fluid in my ears, stroke, did CT Scans and MRI and everything came out normal. It was impossible for me to right in a car! This went on for 3 months. I was nauseous and could only sit in a chair. I was able to watch TV when I took Valium. It was very depressing.
I went through the primary care doctors, ENT and had an appt with a neurologist.I never had a headache prior to the dizziness but had begun to have them when the weather changed.
.
I was diagnosed with vestibular migraines. I learned that you can have migraines absent the pain which if you are going to, that is the way to go. I have begun to have a few with the pain and I know that is not fun. I was put on Lamictal and the dizziness has gone away. I have been able to return to work. It has taken a year to get back on track but I feel confident my doctor diagnosed me properly.
There is not a specific test for vestibular migrations but it is a process of elimination. The best way I can describe it is an over stimulation of the brain. The medications are for seizures and allow the brain to rest and heal. She explained that the nerves get so irritated that they continually misfire.
Your condition sound similar. I wish you the best and hope whatever it is you have better health.
I went through the primary care doctors, ENT and had an appt with a neurologist.I never had a headache prior to the dizziness but had begun to have them when the weather changed.
.
I was diagnosed with vestibular migraines. I learned that you can have migraines absent the pain which if you are going to, that is the way to go. I have begun to have a few with the pain and I know that is not fun. I was put on Lamictal and the dizziness has gone away. I have been able to return to work. It has taken a year to get back on track but I feel confident my doctor diagnosed me properly.
There is not a specific test for vestibular migrations but it is a process of elimination. The best way I can describe it is an over stimulation of the brain. The medications are for seizures and allow the brain to rest and heal. She explained that the nerves get so irritated that they continually misfire.
Your condition sound similar. I wish you the best and hope whatever it is you have better health.
Hello Amy and Dr. Santos,
I have been experiencing very similar migraine symptoms, along with extreme skin sensitivity, loss of balance, a weird need to draw and be creative (I usually do floor plans.) Most recently, I have developed an inability to work with numbers. A week or a year, it makes no difference to me while experiencing these migraines. I have also noticed that of the migraine headaches that I have, the ones with these symptoms seem to mostly revolve around weather changes. Not high or low barometric pressure, just sudden changes. Have there been any advances in how a person can prevent these? I am already on Propanolol for prevention, and Sumatriptan, Tramadol, and Ondansetron as needed for migraine occurance, pain, and nausea.
Thank you for any help or insight.
V/r,
Duchess071
I have been experiencing very similar migraine symptoms, along with extreme skin sensitivity, loss of balance, a weird need to draw and be creative (I usually do floor plans.) Most recently, I have developed an inability to work with numbers. A week or a year, it makes no difference to me while experiencing these migraines. I have also noticed that of the migraine headaches that I have, the ones with these symptoms seem to mostly revolve around weather changes. Not high or low barometric pressure, just sudden changes. Have there been any advances in how a person can prevent these? I am already on Propanolol for prevention, and Sumatriptan, Tramadol, and Ondansetron as needed for migraine occurance, pain, and nausea.
Thank you for any help or insight.
V/r,
Duchess071
MEDICAL PROFESSIONAL
Hi Amy,
How are you? I'm sorry to hear what you've been through for the past days. It is good that both the CT scan or MRI were both normal. Another differential could be hemiplegic migraine which may present with muscle weakness or paralysis, headache, pins-and-needles feeling, numbness on one side of your body, loss of balance and coordination, visual aura, language difficulties, such as mixing words or trouble remembering a word, slurred speech, dizziness, nausea/vomiting, confusion and decreased consciousness. Talk to your doctor about this for proper evaluation. Preventive medications and avoidance of triggers may also help. Take care and do keep us posted.
How are you? I'm sorry to hear what you've been through for the past days. It is good that both the CT scan or MRI were both normal. Another differential could be hemiplegic migraine which may present with muscle weakness or paralysis, headache, pins-and-needles feeling, numbness on one side of your body, loss of balance and coordination, visual aura, language difficulties, such as mixing words or trouble remembering a word, slurred speech, dizziness, nausea/vomiting, confusion and decreased consciousness. Talk to your doctor about this for proper evaluation. Preventive medications and avoidance of triggers may also help. Take care and do keep us posted.
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