Atypical Migraine

    
      Re: Atypical Migraine
    


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Posted by CCF Neurology MD(B) on March 20, 1998 at 10:02:01:

In Reply to: Atypical Migraine posted by Janie  on March 11, 1998 at 11:40:38:

: I'm a woman, 40 yoa, and have been diagnosed with atypical migraine.  In the
   past 2 years I have had only two "classical" migraines - sensitivity to light,
  sound, intense pounding headache that lasts for 1 to 2 hours.
  But my usual symptoms are 1.  a bright spot of light in both eyes that that
  quickly (2 to 3 minutes) intensifies to the point that I am totally blinded,
  2.  Then shakiness, weakness and nausea which progresses (1 to 2 minutes) into a
  severe drop in blood sugar (usually down to 39 to 44 on a glucose monitor),
  3.  Then an uncontrollable humger for salt and sugar (I have actually ripped
  bags open in the store and used both hands to cram chips and cookies in my
  mouth!  It's embarrassing)  4.  Then 8 hour or so of mild headache, nausea,
  weakness and general malaise.  The blood sugar will quickly pop back up into
   the 60's (within 3 to 4 minutes) and then slowly raise back to a normal
  level over the next few hours.
=Dear Janie, Based on the information provided, I would agree with the diagnosis of atypical migraine.  Since these migraines are dominated by visual changes, I would recommend that a MRA be performed(if not done already) to evlaluate for any abnormalities of the intracranial circulation.  While hypoglycemiia can cause headaches, I am unaware if hyponatremia does.  This response to salt may indicate a vascular vs. renal vs. hormonal abnormality.  Because of the unusual qualities of your migraine, it may be beneficial for you to see a neurologist who specializes in headaches.  In addition, it may be also of intrest to discuss with your general practioner about performing a metabolic, endocrine and renal screen.  Hope this helps.  "This information is provided for general medical education purposes only.  Please consult your physician for diagnostic and treatment options of your specific medical condition."
  If I don't take Tenormin 50mg and Pamelor daily, I had a dull aching headache
  that NEVER goes away.  And I mean it lasts for weeks.
  But what is really puzzling to all my doc's (including a neurologist), is the
  fact that if I ingest salt as soon as I get the bright light "aura(?)", all
  symptoms go away within 2 to 3 minutes and I feel just fine.  No nausea, no
  weakness, no lack of energy.  In fact, I had an "episode" while standing in
  a ski lift line.  I ingested half of a small restaurant packet of salt and by
  the time the chair came around, I was fine and raring to go!  I have had
  these episodes 2 to 3 times a day and if I take salt, I'm just fine.
  2 MRI's 9 months apart were normal (with the exception of a small venous bulge
  which was deemed benign).  2 5-hour glucose tolerance tests were normal.  No
  blood level test has revealed anything abnormal.  I can't identify any
  triggers.  I take 1 mcg synthroid, 100 mg Zoloft, 2 mg estrace daily in
  addition to Tenormin and Pamelor.  These episodes began 4 week after a total
   hysterectomy (BAH-TSO).
  I have to add that my General Practioner has been extrememly thorough.  
  The Neurologist confirmed his suspicions about migraine.  Am I just a weird,
   atypical case or are there any other leads my Doctor's might follow?