Possible Basilar Artery Migraine Diagnosis

[Judith__0]

  Although a diagnosis of BAM is being seriously considered by my neurologist,
  I am at present only taking Feverfew twice daily, persantine 75 mg. daily,
  81 mg. aspirin daily and folate.  My MRI was negative for stroke evidence and
  2 EEGs, Doppler carotids, echocardiogram, ECGs.  The SPECScan showed an area
  in the left brain of decreased activity and flow.  My symptoms for which I
  wqas hospitalized for 11 days are as follows: numbness, tingling and weakness
  on the right side from eyelid to foot, which I still have although some strength has returned.  I
  continue to have auras but no headaches and am experiencing continued
  mental confution during these attacks which can last up to 14 hours.  My gait
  remains unsteady.  Prior to the major "stroke" episode, I experienced a
  brief episode of double vision while flying.  I also experience near fainting
  spells.  Have I been correctly diagnosed and should I be more agressively
  treated with drugs other than feverfew?  And if so, what?  Will this resolve
  on its own?
  Many thanks for responding as this is becoming most debilitating.
  Judith
Dear Judith:
Sorry to hear about your medical problems.  Did they look at a MRI with diffusion weighted image?  Since the MRI is normal, and for that matter all you tests are normal the two most likely things that this could be are migraine or epilepsy.  The more likely of the two is migraine.  The normal EEG does not rule out the possibility of epilepsy but it reduces the probability quite abit.  I would favor the migraine diagnosis.  The length of time that your have had the weakness puts you into the Hemiplegic migraine classification while you also clearly have Basilar migraine symptoms.  I think that I would place you in the hemiplegic migraine classification but since I didn't get to examine you, I will defer the diagnosis.  I think that your physicians need to rule out the possibility of mitochondrial disorder (MELAS), and homocystinuria.  Once they arrive at their diagnosis, they will likely start migraine meds.  If the etiology is indeed migraine, then things should resolve.  I hope that things resolve soon.
Sincerely,
CCF Neuro[P] MD