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Complicated migraine with prolonged hemiparesis
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Complicated migraine with prolonged hemiparesis

My question relates to the duration of the recovery period after an episode of complicated migraine accompanied by hemiparesis. Five weeks ago my wife had a sudden, thunder-like, migraine attack during a meeting. She came back home and rested the whole evening with Advil. The next morning she woke up with her lips stretched to the right and still a very strong migraine. OK! we opted for the ER. She was seen right away and they give her Maxoran for the headache. A CT-Scan with staining was done and showed nothing abnormal. As the day was passing, her whole right side was getting numb, and she had difficulty speaking. After about 7hrs, the drug had done its job and the migraine was down. The neurologist came, and did his usual physical examination. She could not squeeze her right hand, and could not keep it up at level, her right eye was very sensitive to light and overall the whole right side had no strength at all. He prescribed an MRI with Gd (brain and neck), discontinuation of the pill, and aspirin 80mg every day.  As the days were going by she was limping on the right side, could not write anymore (she is right-handed) and had not recovered any strength on the right side.  Three weeks later we got the MRI which was normal. We saw a neurologist again and he confirmed the complicated migraine diagnostic. He told us that it may take 6-8 weeks before things come back to normal, prescribed folic acid, VitB and nor-tryptiline 10mg (an antidepressant!). It's been a whole 6 weeks now after the first episode and things are not getting better. Yesterday she had another light migraine, her lips are stretching on the right again at least twice/day, she still has no strength and limps on the right.  OK, that's the story. Now, I guess we sort of have to trust the neurologist but our GP is skeptical and thinks that things should come back to normal more rapidly. We read every websites, look at all textbooks, and nowhere we can read that it could last that long. Needless to say that this skepticism of the GP adds stress on my wife, which will surely slow down her recovery. What I need to know from you is
- how long can this really last? I mean the hemiparesis and the whole recovery?
- how often can the symptoms come back to hunt her?
- can it be something else that a neurological problem?
- what can you suggest? a part from patience?

P.S. she should do a transcranial doppler together with a cardiac Echo, but I doubt that these will provide any more clues.

Many thanks for your reply

James
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Avatar_m_tn
I am a migraine sufferer and hemiparesis is the symptom I have actually become most hopefully about. That said it is a slow road. First I should contextualize myself a little. I am a male and have had migraines since the age of three, and only know that I am 21 do I think I am self aware enough to make lifestyle choice that will actually affect my headaches.  The reason why I am hopefully about my hemiparesis is that there are many movement therapies which can strengthen the connection between the two sides of the body.  I discovered this in a Modern Dance class at college, but have tried Yoga and Tie Chi as well. An exercise practiced every day, a routine of movement that can make you aware of the balances and interconnectedness between the sides of the body can really help.
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Thank you for your question. Although without being able to examine her I can not offer you the specific advice on diagnosis and treatment that she needs, but I would try to provide you some relevant information about her health concern.

I can understand your worrying concern about her migraine headaches & associated hemiparesis and no sure success treatments that you have tried. If she suffers continuous headache, please arrange an appointment with a neurologist right away who will evaluate the further underlying neurological/brain disorders here that may be the main reasons of your migraine like attacks associated with hemiparesis and can provide you an appropriate treatment. In addition, the mainstay of the migraine treatment is always to identify the triggering factors and to avoid them. Triggering factors could be different foods such as cheese, chocolate, alcohol and even few fruits. Other factors that may induce your migraine attack may be contraceptive pills, stress or depression, bright lights, loud noise and traveling. Few women experience headache more commonly during the time of their menstrual periods & at the time of hormonal imbalance. I would suggest careful record of events that have proceeded with the attack and avoid those factors. In addition, try to rest in a dark & quiet room, meditate, have a balanced diet and avoid taking unnecessary drugs. Hope this information proves helpful to you.

Take Care & Regards!!!

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Avatar_m_tn
I am still suffering severe migraine attacks and the key is first of all : Food!!! Then stress , than the others.
I would recommend your wife , an acupuncture treatment , but it must be someone good that already practiced migraines.
Wish you all the best for your wife.
Eitan
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