Desperately Seeking A Diagnosis

[Van]

I had migraines at the end of my menstrual period for the past 5 yrs. that always started with spotted vision, similar to walking into the bright bathroom in the morning before eyes adjust,and dizziness. Last Jan. I had the worst headache of my life that occurred a few days before my period. This headache was different from any other, and the vision problem occurred at the same time as the headache instead of before. This headache included tingling all over like pins & needles, strongest in the hands, feet, and face, sick to my stomach, & dizziness. I used to take Midrin at the first sign of the vision problem which usually stopped the headache from starting, however Midrin did nothing this time. I woke the next day to find the spotted vision, dizzyness and faint feeling still there but no headache. This went on for about 2 wks and I finally became less dizzy, not faint and my vision improved but spots were still there.
  Now every month at the very end of my period, the dizzyness, tingling, worse spotted vision, and faint feeling come back for about a week with no headache. The other 3 wks of the month, I still have spotted vision. During these episodes I can't drive and sometimes can't even see the tv.
  I have seen countless neurologist in Kansas City.Testing has included MRI brain, neck, spine, MRA brain, & neck, EEG, VER, SSER, Sleep study have all come back normal.Routine blood: thyroid, hormone, B12 etc. normal. Taken Depakote,Propanolol,Prednisone,Verapimil,Neurotin,Elavil,CalanS. Stopped birth c. pills after this. I do have high estradiol levels.Please help

[CCF-Neuro-M.D.-JT]

Sorry to hear about your symptoms, glad everything was normal in yo9ur workup. From your description, it sounds like you have menstrual migraines +/- headache, which is thought to be due to the withdrawal of estrogen during thw=e normal menstrual cycle. Traditionally, there seems to be some improvement with high dose NSAIDs like Motrin, triptan meds like Imitrex and ZOmig, combo of tylenol and caffeine, and finally an IV med called DHE. It sounds like you've been tried on number ofpreventive meds also. Did you try increasing the dose right before your periods? You did not mention triptan meds in your post, they are abortive meds, meaning they are supposed to stop a headache if taken as it's coming on.

It's also quite possible that the vision problems may represent daily migraines. This is concerning especially b/c the spots may hamper your driving. It may be that you need a more aggresive (aggressive) med to break the cycle such as IV depakote or IV DHE or even IV steroids as an in or outpatient.

Less likely is the possibility of seizures related to your periods called catamenial epilepsy. An EEG during the spotty vision or lightheadedness would be helpful in evaluating this.

Finally although the vision symptoms are likely migranous related, you may consider getting your eyes formally examined by an ophthalmologist just to make sure everything is ok. Good luck.

[Jazz101]

I am going through something similar to what you are experiencing.  In a nutshell, I suffered from migraines since I was 14, I am now 37, female.  As I got older, my migraine severity and frequency seemed to lessen.  They were always the same...visual aura (zig zag lines) followed by numbness and tingling all over, severe one-sided headache then nausea.  Over the past year, I have been getting no visual disturbance, but tingling and numbness all over, especially in my leg, foot and face, then some nausea but no headache.  These symptoms would last maybe an hour or up to weeks at a time.  I have been to two neurologists who, after a head CT, office exams, heart exams, etc. have diagnosed complicated migraines.  That is, migraine variants but no headache.  I am scheduled for a head MRI next month for my own piece of mind to basically rule out anything else.  If it comes back normal, I will accept their diagnosis and get on with things.  The last neuro prescribed 400 mg of Vitamin B2 and 200 mg of Magnesium per day.  Apparently it takes a few months for them to work - I have only be on them for a month so we'll see what happens.  He also suggested a calcium blocker (Verapamil) but I have not started taking that yet (I am waiting until I feel I really need it!)

I would suggest talking to your neurologist about a diagnosis of complicated migraine and maybe going on the B2 and magnesium.  Good luck!

[Mac53]

Please be kind to my spelling I have no medical back ground and am going to try my best. This is an on going problem of muscle pain & joint. It is what I consider cronic, some days are so bad I want to cry. The area's effected are neck shoulders arms and legs and back. I have seen my family Dr. and they refered me to a pain specialist. He ran some test and cam up with a medical term known as Melbafalmygia (spelling) I am still looking for answers, the medicine he had me on was so not acceptial to my system and job. Viox was one and the other was Ultram , the vioxx tore up my stomach and the Ultram put me on the sofa unable to function the whole day. How is one to live like that?
I just can not accept the fact that I have to live like this the rest of my life. I will keep searching for answers there has to be someone out there that has an answer. Being in this kind of pain 24 hrs. a day has taken a toll on me, making everyday of my life a pain staking struggle not to mention the throw back to my family. If there is any one that my have a helpfull word to share with me please let your voice be heard. Thankyou I will look forward to hearing from you.

[Amjerlin]

I would look in the neurology section under BAM (basilar artery migraine), my daughter suffers from this disorder and some of what your symptoms are sounds like it.  let me know and good luck!

[Van]

Thank you jazz and amjerlin for your comments. Jazz please let me know if you get any benefit from the verapamil. It may be that I didn't take enough. I have low blood press. so they limited me to 180mg per day. Please keep me informed of your findings. I just posted a comment today 2/12/02 under Persistent visual disturbances without headache from Ladyofthelake asked on 2/8/02. This women has the same problems we are having. I put my new findings in that comment. Amjerlin please also keep me informed on any information or help that your daughter receives. I wish you both luck. This is a long and difficult process.