stroke, complex migraine or something else?

[Gemm63]

I have recently been diagnosed as having a right lacunar stroke and a couple of TIAs possibly due to a clot passing through a PFO.  I am awaiting PFO closure.  I was given a CT scan which was clear but not an MRI. I am left with weakness on left side -heavy arm, leg, confusion, dizziness etc.  I have had migraine with aura since 1979 and developed Raynaud's in 1986.  Thing is I had an episode in 1987 after my pregnancy where I leaned forward to reach the coffee table and found I could not move my bottom half.  I had severe pain around the small of my back and hips  - this lasted about 10 mins but I was left with pain and stiffness for couple of days.  i had another episode in 196 where after reading aon top of the bed, I attempted to get up and fell to the floor. It was as if I had no left leg - no sensations for about 10 mins then pins & needles and 'walking on air' feeling. Throughout,m I have had pins and extremely heavy arms and cannot raise them to dry my hair. I get neuralgia tye pain in my legs, knees, finger and toes.  Am exremely sensitive to cold and my eyes are sensitive to bright light/sunlight.  Have also noticed that my left leg buckles when walking or I sometimes trip over my left foot.  Have had numerous chest infections where feel as if my chest has been wrapped in a cold towel and pain on breathing in.  Chronic cough leaves me breathless.  Very easily fatigued, poor memory, urge incontinence.   Could this be all down to previous TIAs or migraine?  Any help would be great.  Thanks

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

In the modern era of the availability of MRI scan, MRI is the scna of choice for identifying strokes. One can get an idea what king of stroke occurred from the history and examination, but often we are still wrong then an MRI is obtained as to the type of stroke. 'Lacunar' strokes are not thought to be caused by emboli or travelling clots as may be suspected with a PFO. They are thought to be due to local small artery disease that clogs up. So before embarking on an invasive procedure like a PFO closure, perhaps your stroke workup needs to looked at again in terms of where the stroke is on MRI, what you blood vessels look like on an MR angiogram and what may be the most likely cause of the stroke. The relationship between PFO and stroke is still a bit controversial - there are trials going to on evalaute the benefit of closure.

The other episodes do not sound typical for TIA or migraine. Briefly the episode in 1996 and 1987 sounds like a peripheral nerve compression in th left leg, or sciatic nerves. You seem to have a lot of other complaints which may not be related to a primary neurological problem - you need to find a doxtor that cna seperate these problemsaout and run the appropriate tests to find out what is causing them. In particular, an underactive thyroid gland should be tested for.

Good luck

[Gemm63]

should have mentioned that I am Female, 42 and my mother had  scleroderma with CREST, lupus, raynauds. Often when I mention any symptoms my husband says that he gets that - my husband has Relapsing remitting MS.

[Gemm63]

My husband is 41 and was diag 15 years ago.  Initial symptoms were severe headache, drooping mouth, slurred speech,loss of feeling down left side from the neck down and right side of his head. Total numbness - he remembers being in the bath and only feeling water on one side of his body. He was admitted to hospital and initially was thought to have had a stroke.  He was in hospital 6 weeks and had MRI scan which showed several lesions in his brain, visual tests (VEP?)to monitor his co-ordination etc and Lumbur Puncture which confirmed his diagnosis.

Initially he left hospital in a wheelchair, continued with physio and progressed to walking with a stick. After 6 months he went back to work and suffered another relapse.  This time it was the left side of his head and right side of his body.
I only met my husband 10 years ago and in that time, although he has had a few relapses, none have been as bad as his initial attack.  He has been in hospital 3-4times in total for IV steroids and at the moment only takes painkillers.

He doesn't work but leads a normal life and no longer walks with a stick but has been left with a niggling neuralgia type pain and pins and needles in his face and an extremely pain-sensitive area around his middle - lower back. Apparently due to de-myelination.  His legs still feel heavy, he walks with a slight limp and is easily fatigued but it doesn't stop him looking after our me and the kids, 19, 15 and 6.
Hope all goes well for you.