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Numbness in Tongue And Face
My sisterin law has been having these numbness in the tongue and face both sides. Her bloodpressure goes up very high ( 190/125). She has no headache but has been diagnosed as having Silent Migraines. Her health otherwise is good. MRI and CT scans have come back clear. My Question is: Can these symptoms be Silent Migraines.
MEDICAL PROFESSIONAL
Hi,
What is significant to point out in your sister's case is that she has uncontrolled hypertension and her scans only showed relatively normal results despite the neurologic symptoms. In your previous posts, you have mentioned that several tests have been done and the results were always normal. But the attacks continue to occur.
Has her coagulation factors ever been evaluated? This includes Prothrombin, aPTT, fibrinogen and homocysteine levels. Also, were they able to determine the cause of her hypertension? Is this primary hypertension or are there other underlying causes that may have caused a persistently increased blood pressure. Her kidney function and even adrenals may require some evaluation.
I understand that your sister's quality of life has been greatly affected by her condition. A diagnosis of a basilar migraine may be a primary differential at this point. If this is indeed the diagnosis , the attacks may be unpredictable and your sister needs as much support and guidance. She should not leave home alone or drive alone. Her friends and colleagues need to be informed of her condition.
Discuss this with the physician and also discuss the advantages of preventive migraine therapy. The usual migraine medications like the triptans are not advisable in cases of complex migraines.
Is your sister taking nay beta blockers for her hypertension? I suggest that if her condition is indeed a migraine , the use of calcium channel blockers may far benefit her than the use of beta blockers.
Here is a url that you might want to look into.It contains an abstract of a study on migraines and some interesting points:
http://www.ncbi.nlm.nih.gov/pubmed/11471758
What is significant to point out in your sister's case is that she has uncontrolled hypertension and her scans only showed relatively normal results despite the neurologic symptoms. In your previous posts, you have mentioned that several tests have been done and the results were always normal. But the attacks continue to occur.
Has her coagulation factors ever been evaluated? This includes Prothrombin, aPTT, fibrinogen and homocysteine levels. Also, were they able to determine the cause of her hypertension? Is this primary hypertension or are there other underlying causes that may have caused a persistently increased blood pressure. Her kidney function and even adrenals may require some evaluation.
I understand that your sister's quality of life has been greatly affected by her condition. A diagnosis of a basilar migraine may be a primary differential at this point. If this is indeed the diagnosis , the attacks may be unpredictable and your sister needs as much support and guidance. She should not leave home alone or drive alone. Her friends and colleagues need to be informed of her condition.
Discuss this with the physician and also discuss the advantages of preventive migraine therapy. The usual migraine medications like the triptans are not advisable in cases of complex migraines.
Is your sister taking nay beta blockers for her hypertension? I suggest that if her condition is indeed a migraine , the use of calcium channel blockers may far benefit her than the use of beta blockers.
Here is a url that you might want to look into.It contains an abstract of a study on migraines and some interesting points:
http://www.ncbi.nlm.nih.gov/pubmed/11471758
My daughter suffers from complicated migraines that include abdominal migraines, hemiplegic migraines, and basilar type migraines. I have had to do much research on the subject as the doctor's are finding her a very complicated case. I just wanted to comment in my research I have found there are cases of migraines without any headache or any pain for that matter. It sounds as if what is being experienced here is actually a type of aura. Also most EEG testing as well as MRI testing will all come back normal. Sometimes if the patient is actually experiencing an attack it will show up , but not likely even then . I would suggest finding a migraine specialist in your area. Also with the type of migraine the patient is suffering from in your case usually always puts the migraine sufferer at higher risk of stroke. Triptans should not be used in this case from all that I have read and that may be what some doctors would prescribe . I hope you will seek additional info from various sources. God Bless and good luck!
Sorry I have not replied for so long. We spent Easter with my Sister in Law and she had an attack while I was there. Suddenly her voice became slurred, and her face and tongue became numb. She found it hard to swallow. I took her B/P and it was 240/135. Pulse 120. Took her to the hospital and they left her lying on a trolley from 1030 to 1700 when they gave her a tablet to bring down the B/P and let her come home.
They kept saying it was a migraine even though she had absoutely no pain. I became one of those ex nurses that start to question how they reach their diagnosis. She has no deficit in either arms or legs. Her face does seem to fall on the left side but only margainly.
I asked the Dr. if it could be due to any type of cardiac problem even though she has not had a problem with her heart. He has referred her to a Cardiaologist and her appointment is 1st July.
She is absoutely compliantant with her blood pressure medication and while she does not have these episodes her B/P is around 160/110 which is high anyway. She is also stressing out and terrified of having a stroke. I did suggest that she ask her GP for a mild antidepressant drug to help her become less stressed but she is against taking anti depressants. It seems that the turns she has are worse each time but not as frequent. The one at Easter was over a month since the one before. Again she has had a Brain Scan, MRI, Ct, Blood tests, and all have been normal
They kept saying it was a migraine even though she had absoutely no pain. I became one of those ex nurses that start to question how they reach their diagnosis. She has no deficit in either arms or legs. Her face does seem to fall on the left side but only margainly.
I asked the Dr. if it could be due to any type of cardiac problem even though she has not had a problem with her heart. He has referred her to a Cardiaologist and her appointment is 1st July.
She is absoutely compliantant with her blood pressure medication and while she does not have these episodes her B/P is around 160/110 which is high anyway. She is also stressing out and terrified of having a stroke. I did suggest that she ask her GP for a mild antidepressant drug to help her become less stressed but she is against taking anti depressants. It seems that the turns she has are worse each time but not as frequent. The one at Easter was over a month since the one before. Again she has had a Brain Scan, MRI, Ct, Blood tests, and all have been normal
Please excuse the bad spelling of above post. The Hospital is St. Vincent's Hospital in Sydney. It is one of Australia's best hospitals.
Patricia had a full medical when she rurned 70yr. She passed with flying colours with B/P, Cholesterol, Liver and kidney functions blood teasts. She is not diabetic and not overweight weighing 60kg and is 163 cm .
Her attacks have lessened but when she has one it is getting worse. They kept her Emergency at the hospital last time from 7pm until 0400 until they could get her to be able to swallow a anti hypertensive tablet. By that time her B/P was 130/125. They are still calling them silent migraines.
She is very compliant with taking her meds as she is so frightened of having another attack.
Still has no visual disturbances or and deficet in her limbs.
I have suggested that she get a referral to ZSt. Vi9ncxents Hospital in Sydney NSw and see a specialist consultant Neurologist.
Her attacks have lessened but when she has one it is getting worse. They kept her Emergency at the hospital last time from 7pm until 0400 until they could get her to be able to swallow a anti hypertensive tablet. By that time her B/P was 130/125. They are still calling them silent migraines.
She is very compliant with taking her meds as she is so frightened of having another attack.
Still has no visual disturbances or and deficet in her limbs.
I have suggested that she get a referral to ZSt. Vi9ncxents Hospital in Sydney NSw and see a specialist consultant Neurologist.
MEDICAL PROFESSIONAL
Hi,
The increase in blood pressure may have contributed to her symptoms. Good compliance to the antihypertensives and a close supervision by her physicians may be necessary.If she was a diagnosed hypertensive prior to this admission, then a silent migraine may not be the primary differential .
The increase in blood pressure may have contributed to her symptoms. Good compliance to the antihypertensives and a close supervision by her physicians may be necessary.If she was a diagnosed hypertensive prior to this admission, then a silent migraine may not be the primary differential .
Patricia has had a CT Scan, EEG, Brain Scan and MRI and ECG .All have been clear. In fact the Doctors are always very pleased with the results due to her age. She has been put on blood pressure medication after her first attack on 28th Dec. They have also got her on an anti dpressant as she is getting very stressed about these turns. They seem to be gettiung worse each time , however the frequency is not as much. I just feel that to call these turns Silent Migraines is a bit of a coplout because they don't know what is wrong. In the begining they were calling them TIA's but have ruled that out.
Thank you for your help and concern. It is just so frightening for her and us. She is more like a blood sister to me than a sister in law.
Thank you for your help and concern. It is just so frightening for her and us. She is more like a blood sister to me than a sister in law.
MEDICAL PROFESSIONAL
Hi,
Was a complete work up done?
Are there any underlying diseases like diabetes?
She may need a complete assessment given that with her symptoms her blood pressure shoots up and you have mentioned that this is not associated with any pain. Is she taking any medications to maintain her blood pressure?
A cardiac evaluation including evaluation of peripheral blood vessels may be needed.Coagulation factors also need to be assessed.
Were these done aside from the scans? Migraines are given as diagnosis when other possible conditions like a transient ischemic attack, bleeding disorders, or musculoskeletal disorders have been ruled out.
Do keep us posted.
Was a complete work up done?
Are there any underlying diseases like diabetes?
She may need a complete assessment given that with her symptoms her blood pressure shoots up and you have mentioned that this is not associated with any pain. Is she taking any medications to maintain her blood pressure?
A cardiac evaluation including evaluation of peripheral blood vessels may be needed.Coagulation factors also need to be assessed.
Were these done aside from the scans? Migraines are given as diagnosis when other possible conditions like a transient ischemic attack, bleeding disorders, or musculoskeletal disorders have been ruled out.
Do keep us posted.
My Sister in law has had no visual or limb extremity effects. She is 71yrs of age and apart from being in hospital for this the last time she was in hospital was 46 yrs ago when her youngest son was born.
She had another attack on Sat2nd Feb ion which her B/P went to 205 /125. She could hardly swallow by the time she got to hospital. She has absoutely no pain with these attacks but is getting very stressed about it all.
She had another attack on Sat2nd Feb ion which her B/P went to 205 /125. She could hardly swallow by the time she got to hospital. She has absoutely no pain with these attacks but is getting very stressed about it all.
MEDICAL PROFESSIONAL
Hi,
The scans came back clear and this has ruled out an underlying bleed or lesion as a cause of her symptoms. Migraines with aura may present with some neurological
(negative symptoms as they refer to them ) deficits like numbness, tingling sensation, and visual problems. Migraine is a strong differential for your sister in law's case.
Was an EEG done?
Do keep us posted.
The scans came back clear and this has ruled out an underlying bleed or lesion as a cause of her symptoms. Migraines with aura may present with some neurological
(negative symptoms as they refer to them ) deficits like numbness, tingling sensation, and visual problems. Migraine is a strong differential for your sister in law's case.
Was an EEG done?
Do keep us posted.
i too have experienced similar symptoms , i do suffer from painful migraines, but i also get the tingling, numb face, feel lethargic and my blood pressure shoots up. gp told me it was migraneous symptoms i was having. she hs my sympathy, i feel as though im imagining it or neurotic half the time!!
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