silent migrane

[denc]

I have experienced headaches and fatigue for the past 4 years after 3 car accidents.  None of these symptoms before the accidents. Headaches are mostly at the temples, usually one side at a time, but can also be in forehead or shooting through eye.  Sometimes sharp pains lasting few seconds through brain that hurt. The headaches dominate my day and can last for several days before abating.

I have the following symptoms, always followed by fatigue but they are not always followed by a headache. About a half hour before fatigue sets in I have a lot of tearing from my eyes, numbness below lip and feel some head pain.  Then exhaustion, I need to lay down.  At this time I feel shivers in my arm and thighs and pins and needles feeling in my feet or hands.

Doctors have looked at MS and Lupus.  I have had MRI's with white leasions appearing in the brain not typical or MS.  I have had a physician who saw me twice say it was Lupus, as my ANA was higher, however I thought Lupus needed to be dignosed over a longer period than two 20 minute visits.  Another neurologist said it was demylating disease and recently a third neuro said it may be a silent migrane.  Is there such a thing as a silent migrane?

I have tried many headache medications from Zomeg to Imetrex - none are work.  Recently I tried anti- infammatories.  These made the headaches worse (in severety and frequency) and last 9 days in a row.

[CCF-Neuro-M.D.-CS]

There is a form of migraine called acephalgic migraine, meaning having all the migraine symptoms including auras with no head pain. Migraine is a very diverse disorder which can cause many neurologic symptoms. Therefore this may be one possibility. Lupus and MS are also  diverse disorders with many symptoms.

The best advice I can provide, is for you to be seen at an academic center. You should probably start by seeing a doctor who specializes in MS, and then perhaps a rheumatologist. These individuals will require all of your previous records, and then can review the information and complete your evaluation. This is most likely your best chance of obtaining a unifying diagnosis and treatment plan. Good luck.

[denc]

I wanted to add that 14 years ago I had a neuritis in one eye.  This left me without sight in that eye for a few days. Site in that eye has  returned with just slight dimming in very stressful times. I saw an MS specialist at that time who took an MRI and indicated that this was not likely MS.  The MRI in 1990 showed white lesions on the brain.  Years later MRI's of the brain in 2000 and 2002  have shown no changes in size, location or amount of these white lesions.  I have had neurologists explain that this is likely not MS but there may be evidence of demylenating disease on the one optic nerve.  

I just find it curious that I had never had headaches or fatigue before the accidents and now they totally dominate and limit my daily activities.   Is it possible that these white lesions can cause headaches or is this not typical?
Can demylinating disease cause headaches and fatigue?
If this were a migrane, would one expect that typically  anti-inflamatories would make the headache worse or reduce the pain?

[nosol]

Hello,

Sorry you have to feel so much pain.  Your Sx do sound typical of migraine, what I think is often referred to as cluster headache/migraine type with tearing and other associated symptoms prior to the headache.  It is somewhat surprising that typical antiserotonergic meds (e.g., Imitrex) have not helped you so far -- how many times have you tried?  -- but some types of migraine are not helped by these meds all the time.  

I think it is wise to look into the possibility of MS because of the lesions in your brain.   Depending on when your last MRI was, you should consider retaking it to see how those lesions have behaved since your last scan.   In light of this and the possibility of other autoimmune disorders, perhaps some oral steroids trial could be of benefit.  

Although, frankly, a lot of people tend to suffer from severe headaches after any type of trauma.   Also, trauma is often resulting in concominant depressive mood or a full-blown depression, symptoms of which may include headaches and other somatic pains.  I would consider this possibility as well but not after you rule out any other organic etiology/cause.

Good luck!

[Cindylou]

Because of the 3 accidents you had, you may have suffered whiplash or another muscular trama.  Have you gone to physical therapy or massage therapy?
the headaches could be caused by the scalenes or scm's in your neck.  
Also the trap muscles that connect from your back to the base of the neck can cause the headaches.  They can then trigger pain in your head, temples,eyes,ears etc.  I suffer from this and at best my headaches are at a dull roar and that don't really need medication.  I found massage therapy helped the most. Go to someone who specializes in trigger point therapy.  I found it calmed the anxiety caused by the pain and some of the pain actually seized!

[eloridas]

Hey denc,

I know it is difficult too be going through such nasty symptoms.  I had been diagnosed twenty years ago with rheumatiod arthritis--and the doctors all saw this goingon--though I had sero negative blood tests.  My rheumatologists have been VERY thorough and they will "dip" past jsut rheumatic disorders too make sure that the symptoms are not caused from other disorders and talking from experience, mine have always been great in reducing my pain.  They have had difficult "other" disorders too deal with also and rheumatologists work with all types of disorders that can mimick autoimmue disorders also.  Only thing sometimes they take time too diagnose--in my case I have just recently been diagnosed with Lupus (SLE) has always been there in the back of my mind--and the treatments were always given with the thought that my RA was possibly Lupus (their treatments are similar/same).  Anyway--I wanted too jsut comment that at least the doctors seem too be taking your symptoms at least seriously by doing the head MRI also.  Hope you get some relief soon, eLori

[gothair2dye]

Oh this is exactly what is going on with me.
DX with Lupus 5 years ago, but...that is now unclear as I woke with blurred vision then lost speech (a studder) just like a stroke, anyway lots of tests, if I have Lupus it is in remission they say, MRI CAT are clear, and suddenly I have migraines, but silent ones too, so they say I am going to the Univ of W for tests this week. but does this sound right

weak feeling,(almost dizzy but not quite) your body feeling strange? then neck pain or eye pain, extreme fatigue, then something happens you can feel a change like whatever happened is over but you have been hit by a truck and need to rest, maybe nauses? Are your hands cold? feet cold, or feel numb and look like you have been soaking them in water for hours?
People say they see it happen in my face, my skin changes color and I look like death.

Other times now I get the same thing only with pain, sensitive to sound and light really bad then it feels like someone is digging there heels in my head, I can feel the raging river of blood running in my head. My nero says these complicated migraines probably casued the speech and vision problems, those times I had no head pain at all. They say they can last for 72 hours, but rare to last longer, mine have lasted for days once I broke it I cut down on all the caffeine and other triggers very slowly or you'll get a headache, I spaced coffee out all day then 1/2 decaf etc..mine seem to be hormone triggerd so far, keep a chart of your silent migranes how long they last what it feels like etc..it only took 2 months to find some of the triggers for me to feel a little better.
Good luck I am also still searching for answers.

I use axert for the migraine so far it helps, talked to friends with migraines and found ice on my neck helps too, heat is bad. look up complicated migraine, also read lupus sl symptoms, it is possible with your symptoms that I doctor can suspect it so quickly. But it took me 17 years and now they think maybe MS not lupus or Lupus in remission and who knows what!!! hang in there