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differance between TIA and migraine

I am 50 year female with FMD, diabetes , hypertension and have a history of silent strokes. SInce I am an risk for having a stroke how does one know that they are having one. I have gone to the ER with one sided numbness and tingling w/ a bad headache the ER Dr. will say TIA but when I see neurolist I am told migraine. How can I tell if it is a migraine or a TIA? Thanks
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MEDICAL PROFESSIONAL
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 full history, I can not tell you whether or not your symptoms are due to migraine or TIA, however I will try to provide you with some information.

First, it is important to note that when a migraine is associated with neurologic symptoms, this is termed complicated migraine, meaning the usual headache and other headache associated symptoms are accompanied by unusual symptoms such as tingling, numbness, weakness etc.

A TIA, or transient ischemic attack, is due to a transient decrease in blood flow to a part of the brain. The symptoms that occur depend on which area of the brain is not receiving blood.

Differentiating TIA from complicated migraine is not always easy. Certain features can however be helpful. For example, TIAs are typically not associated with headache, so in the presence of headache, complicated migraine becomes more likely. (However it should be noted that if someone who doesn't usually get complicated migraines suddenly gets a headache associated with other neurologic symptoms it could be due to a bleed in the brain and this would need to be ruled out).

Also, with a TIA, the symptoms can usually be clearly localized to a specific distribution of a blood vessel. For example, if someone has transient right sided weakness associated with inability to speak, this would be due to a specific artery on the left side of the brain.

As you can see, the distinction is not very clear. For a neurologist, certain aspects of the history as I mentioned above aid in the differentiation. While it is very important for you to educate yourself on your condition, the distinction between complicated migraine and TIA would be difficult for you to determine without the medical knowledge that a neurologist has. It is important for you to always err on the side of caution when you develop any neurologic symptoms and discuss these with your neurologist asap, because TIAs are a harbingers of stroke, and as you may know, diabetes, HTN, and FMD all increase a person's risk for stroke. It is important, independent of whether or not you have TIAs, to control all of these as best as possible with medication, diet, and exercise.

Thank you for using the forum, I hope you find this information useful, good luck.
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A related discussion, TIA vs. Complex Migraine was started.
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