Is this a TIA

I am a 51 year old female.  Two years ago I thought I was having a stroke due to pressure in my head, disorientation sudden lack of coordination and not being able to get my words to come out right extreme fatigue and lights bothering my eyes.  They did tests and could find nothing.  I was told it was probably a TIA or a small seizure and to keep taking aspirin.  In November I had the same symptoms and was told to go to the ER.  More tests, same results.  For the past few days I've had the feeling of someone putting pressure on my forehead, dizziness and being very tired, lights bothering my eyes and just wanting to close my eyes.
It's been three days with a few breaks of feeling normal but the majority of the time I feel the symptoms listed.  Any suggestions of what to do next?

[Sara Khan]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.

Without the ability to examine you and obtain a history, I can not tell you what the exact cause of your symptoms is. However I will try to provide you with some useful information.

In Neurology, the 3 most common causes of transient neurological symptoms are : TIA, seizure and migraine. In your case I think you have migraines.

Classically migraines are described as one sided headaches, sharp, associated with nausea, vomiting, and aversion to light and sound. People suffering from migraines want to be in a dark quiet room. This is a classical presentation. However there are numerous variation in presentation. Especially as you get older, it is less likely to present in the classic way. The headache can be a small component, and may just be associated with pressure. It can often be mistaken as a stroke, because of symptoms like vision changes, confusion, or weakness, which all resolve. A lot of time people have a history of  headaches in their adolescence which completely resolved, and not later in life present in a different way. If not a migraine it is likely to be another variant of headaches, like tension headaches or chronic daily headaches.

Usually if rare we treat these headaches with over the counter Aleve, or tylenol. However if they become really frequent that they start affecting once life, there are numerous medications out there which are given as prophylaxis to prevent further headaches and as abortive treatment once the headaches actually start.

It would be good for you to see a headache specialist if there is one near by. If not, your regular neurologist should be able to evaluate you if you tell them the symptoms you have detailed above. Of course there are a lot of questions to be answered to correctly identify the category of headache and thus determine the appropriate treatment.

I hope this helps.

Good luck!