complex migraine

My sister has recently been diagnosed with a complex migraine and has numbness in her left arm and her speech has been affected.  Nobody seems to know what to do, what causes this and what the timeframe is for her to regain her speech and total movement in her arm.  She has been hospitalized for 3 days and all they seem to do is send in therapist that tell her there is nothing they can do, they will send someone else.  

How do you know if she is ok to go home and be alright.


This discussion is related to TIA - A-typical Migraine?.

[Abhijeet Deshmukh, MD]

Hello.

I would seek a neurologist's opinion to rule out any other cause behind the symptoms of speech deterioration. Migraine is known to be associated with numbness, but is speech is affected, I would suspect a lesion in the cerebral cortex or the cerebellum. A transient ischemic attack would be on the list to be ruled out.

What did the MRI report say? Is the speech defect persistent?

Regards

[concerned1631]

They have ruled out stroke, they have diagnosed that it is a complex migraine to the best of her knowledge.  The MRI stated no lesions or tumors or concern on the brain.  Her speech sounds like a stroke patient.  She has no loss of memory or trains of thought.  

Her left side is very sensitive even to air.  Her left arm is still numb but, leg has all the feelings back into it.  

What is the timeframe we should expect her to regain her speech.

[Abhijeet Deshmukh, MD]

Hello.

It seems other probably causes are pretty much ruled out. In such a case, we can consider the speech problem to be arising from the complicated migraine. Since the speech is like a stroke patient, it is probably slurred and discontinuous. I guess there is no loss of content and thoughts. The time period of the speech defect is not so long in complicated migraine, but it can last up to a couple of weeks. Your sister's looks like an unusual case.

With appropriate migraine control, she should regain her speech within a week. But given her prolonged speech deficit, she may take more time.

Regards

[music234]

I am a 46 y o female and I was in the hospital for 4 days with sudden onset slurred speech and heavy coordination with left side weakness. It appeared to be a stroke. On the 3rd night MY SPEECH RETURNED to normal except for now 8 weeks later I still have weakness that comes and goes. I also have pins and needles in waves down my legs less frequent as the days go by. My muscles randomly twitch slightly at night. I thought that my thinking was not changed in the hospital but when I try to explain things that requiring thinking on the fly- I stall slightly mid sentence although I don't have slurred, slow speech anymore. The Neurologist also said migraine after all else was ruled out. I am so thankful to have my speech back and that my left side weakness is so much better.
I was checked for Lyme disease and had a CT scan, mri-mra with contrast, and questioned if i had any exposures to toxins or chemicals. Have they done this for your mom? I will pray for her. Keep us posted.

[music234]

I realized you are talking about your sister not your mom. I am hoping the best for her. I know what she is going through. Encourage her to not be afraid and to think the best. Every time they rule out something like stroke or a bleed or a tumor, there is reason to be thankful.

[concerned1631]

Thank you for you prayers.  They released her today from the hospital however, the headaches, numbness in face and left arm.  The have done CAT scans, MRI's and today they did EEG.  Her memory is there the words are hard to say for her.  I hope that changes soon.  What did they put you on?

[concerned1631]

I asked some questions of the doctor today in regard to the test results.  They also did an EEG this afternoon but, we have not heard the results as of yet.  The thing I don't understand is why with all the medicine available for migraines including a shot, why they wouldn't give these to her to reduce the pain or actually get rid of it.  They are giving pain medicine and have now prescribed TOMAC and percacet.  Her left side of face and neck are still numb like with pain constant as if pins are sticking her.  Her left arm isn't functioning correctly either.  She had a stroke 9.5 years ago after giving birth and the same numbness happened for 1 or 2 weeks but, never anything with her speech.

One doctor today compared it with him as a child having to move to a new neighborhood as a teenager and him getting sick because he didn't want to go to the new school.  Maybe, it was psychological.  that is crazy....

[music234]

They offered me pain meds but I declined because my pain was not that bad. I tend to decline when offered unless it is absolutely necessary. I didn't want to mask any new symptoms with medicine and I wanted to think clearly as I researched my condition. I listed out my events and timeline along with tests results and tests suggested. I encourage you and your sister to find doctors you trust and who trust you. Get second opinions and request copies of labs and test results. Keep us posted. She is blessed to have you. Keep encouraging her to trust that everything will be OK. Fear is the worst part of not getting a diagnosis. Think the best, it will help you come through this time stronger.

[concerned1631]

She is the same today however, the doctor that release her from the hospital yesterday prescribed medicine that is not to be taken with the blood pressure medicine she takes.  It is scary to think that they can't take the time to review chart prior to prescribing medicine.  This alone can cause more problems.  Her speech is the same, she is trying to use her arm as much as possible.

[concerned1631]

Have you had a chance to review my last question to you?

[Abhijeet Deshmukh, MD]

Hi.

I hope her blood pressure is under control with the medication. Did she miss a few doses just before these symptoms started? It appears that her symptoms are due to some persistent problem such as reduced blood supply. An EEG is ordered as they still think there could be a structural/functional damage in the brain which is not picked up by MRI.

Please let me know the EEG report when it comes.

Regards

[concerned1631]

They are not telling us anything.  Is this normal, shouldn't the patient be kept abreast of the findings on all the tests.  They didn't tell blood results, CAT scans, mri's, EEG or EKGs.  I am assuming because there may not be anything showing but, a simple hey the tests came back clear.  I have no idea.  They do want to redo the MRI since something on the front of her head seem to be unclear.  No further information was provided.  They said it could have been caused by her moving a little bit.  This is a $1200 or more test, it is not like a plain xray.    She is a cancer survivor and obviously, this scare us to death that it may be something different from a migraine.  She had mini strokes after her daughter was born.  They told us then it was common.   She has been treated at this hospital for 10 years on biopsies and these docs were suprised to hear this.  Isn't ready a chart and health history help to determine what is going on or what has gone on in the past.  The want her to remain calm but, as you can imagine that is not that easy.  

[concerned1631]

Not much has changed since I wrote before, I hadn't heard back from you and was wondering if there was anything in particular we should ask the neurologist tomorrow at the appointment.

[akaartist]

I have the same thing as your sister. They are familial hemi paraplegic migraines, What happens is that one whole side of the brain is have a migraine basically the brain is over stimulation and there is  an electrical storm that is going on. There is a three shot combo that i have to get when I go into the hosptail. She will most likely need an EKG and MRI doen to confirm

[artist56]

my sister in law had what we, and the hospital, thought was a stroke a few months back, they sent her home. Since then she has been hospitalised three times with strokes, and a fourth whilst she was still in hospital. None of the scans showed anything so now they are saying she has paraplegic migraine. I thought this was rubbish until I discovered this website. In the uk we have adverts on t.v. warning us of the symptoms of stroke so that we can medical help asap. It now transpires those exact same symptoms also relate to migraine. Incredible !