Migraine with Aura

You were very helpful concerning my son in the post below so I decided to ask a question about myself if thats okay.

When I was pregnant with my 4 year old at age 36. I developed a aura they say with the flashing lights and jagged lines and temporary blind spots that passed after about 30 minutes..sometimes I got the headache sometime I did not..Also my face would tingle and my lips go numb..I had several episodes and suddenly it stopped. After she was born there were a few more and then gone until October of 2000, My father in law died and then suddenly 3 weeks later my mom died and then at my next period the Aura returned..Jagged flashing circles of light that distort my field of vision for 15 to 30 minutes, sometime I get numb in the face and arm or leg, sometime there is a bad headache sometimes no headache at all..sometime nasuea, sometime an extreme panic/anxiety attack will follow..I cannot stop shaking or paceing or crying I shake and hyperventilate and feel like I am dying..I usually have to take a Vistaril to calm me and the nasuea..I cannot contcentrate after this, I also will develop some jerks which they say may be Myoclonic..Its always around my period..I have had normal MRI's and CT's..I just had a CT in September becaues of one episode two months before my mom died..It was normal as have been all the MRI's ever done. This scares me. They say complicated Migraine, I am on Inderal but I still get them and then I have a dull headache for days at times...I also get frequesnt parathesias in my hands and arms and face and some twitches..This they say may be caused by the fact that I have Porphyria(Acute Intermittiant) and they say also Benign Fasics syndrome...What exactly is complicated Migrane (migraine)? This past month I woke up got the Aura got a bad headache took tylenol after two hours headache subsided mostly and Boom aura again and Headache..Can they occur so close together? How would I tell if it was a TIA or Stroke? How do I not assume everything is Migraine?..I am 40 Good BP, The only risk factor is Hereditary Factors(mother) and her family. No heart problems etc...Does this increase my stroke risk? Also there are frequent sharp stabbing pains near my temple/ear off and on that pass quickly...Your input would be so welcome and appreciated...

[CCF Neuro[P]-M.D.-RPS]

Dear BJP:

I am sorry that your having many health problems.  Your porphyria may be causing some of your motor symptoms, but usually it does not cause sensory changes (paraesthesias) as the dominant feature.  Sensory problems can be caused by a great many disorders and I would check with your neurologist.  So your fasciculations might be due, in part to yoiur porphyria.  There is a condition known as late-like migrainous equivalents or migraine aura without headache.  You are alittle young for this, but it can happen in your age group.  However, one must rule out things like epilepsy, thrombocytopenia, hyperviscosity sydrome and antiphospholipid antibody syndrome before one feels comfortable with this diagnosis.  Once these things have been ruled out, then the diagnosis can be made.  There are usually no permanent sequelae with this syndrome.  However, I would first get checked for the other mentioned conditions before feeling like this is your diagnosis.   Let us know how you do.

Sincerely,

CCF Neuro MD