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  : : My 15 year old daughter has complained of dizziness with a visual aura(zigzaggy lines,etc.) and headache following.  She was diagnosed as having migraine headaches, which, I , her mother also have. My question is that on two separate occasions, she has complained of numbness in an extremity. The first time she had nunmbness in her arm and today she complained of numbness in her right leg and the same time she complained of being extremely dizzy. Is dizziness and the numbness part of the migraine? Thanks for your time.
  : Dear Nancy:
  : Sorry to hear about your daughter (and also your) migraine headaches.  It is unclear to me whether the dizziness and paresthesias go together with you daughter's migraine.  Yes, both can be associated with migraine, but usually the headache appears with these symptoms and if your daughter doesn't have a headache with the symptoms then they may not be part of the migraine problem.  It is difficult to say when I have not examined your daughter nor do I have her history.  What medications is she taking for her migraine headaches?  Are her headaches well controlled.  The most likely explanation is that yes indeed her numbness and dizziness are a part of the migraine problem.  In addition, the medication that she is taking might be causing the numbness.  I would tell your pediatric neurologist and see what she/he says about these issues.  Sorry, I can't give you a better answer.
  : Sincerely,
  : CCF Neuro[P]MD
Dear Nancy:
Thanks for the added information.  How often does your daughter get her migraines, are they associated with her period?  Yes, these additional symptoms, MIGHT, be part of the migraine process.  In our following bad headaches over the years headaches can be the result of migraine, chronic non-progressive headache, and another that is associated with neurological features that require further investigation.  Without examining your daughter I can not tell the first from the last possibility.  I would seek a second opinion from a pediatric neurologist familiar with migraine headaches in the teen-ager.  She needs a full neurological exam to rule out the possibility of the third possibility.  If the migraines are fairly regular, then she needs treatment to prevent the migraines from starting.  However, if the migraine-like headaches are the result of a neurological process, then that process needs to be addressed.  The most likely explanation is that this is migraines and your daughter needs to be treated
appropriately.  However, to rule out the third possibility you really need to have your daughter undergo a thorough neurological examination.  If you live in the Cleveland area we would be happy to see her (1-800-CCF-CARE).  Let us know what happens.
CCF Neuro[P] MD

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