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Re: TIA and Migraine Symptoms

Posted By CCF MD on October 16, 1997 at 09:11:03:

In Reply to: TIA and Migraine Symptoms posted by Michelle Hinn on October 07, 1997 at 02:11:27:

: Hi,
This is a follow-up to my posting a few weeks ago about some odd neurological
symptoms that I have been having. Both my CT scan and MRI, plus blood tests,
showed no abnormalities which is great! The only downside is that I am
still unsure of what is causing these symptoms. The neurologist that I went to
here (Illinois) did not seem to think that I was having any kind of seizure,
since the "episodes" follow a definate hormonal pattern (they occur within a
week of my menstrual cycle). When I get these episodes, I have a flash of light
in my right eye which moves to take over my visual field in that eye and lasts for
about a half an hour. This is accompanied by numbness on the right side of my
face and right arm, slurred speech, confusion and mood changes. There is never any headache involved. The entire episode (the numbness and confusion and not the flash of light) lasts between 48 to 72 hours. The doctor
said that since I am only 27, he thinks that this is probably an odd kind of migraine which has TIA-like
symptoms. What kind of migraine could be causing stroke-like symptoms? How will I know if I am really having a stroke or TIA? I am not overweight, do not smoke, regularly exercise and am taking no medications.
Thanks again for your help! This is a great service that you provide!

Great question and I'm glad that your scans have been normal. The question of
migraine and stroke has been a debated subject with proponents on each side.
The relative risk for stroke in young females with migraine with aura is 6.8, with
smoking it is 10 and with oral contraceptives it is 14. You do not smoke and take
no medication so those are both very positive things. There are several disease
states associated with both migraine and stroke. These include antiphospholipid
antidoby syndrome, systemic lupus erythematosis, essential thrombocytopenia and
CADASIL (Hereditary Autosomal Dominant Arteriopathy, Subcortical infarcts, and
Leukoencephalopathy). You can ask your doctor about these. Your symptoms do sound
like migraine. I'm not sure if you are using any abortive medications but it may
be reasonable to try a prophylactic medication (to prevent the attacks). You could consider one of
the calcium antagonists such as verapamil. (I did not see you first question so
sorry if you have already given some of this information). I would also recommend
screening blood tests for some of the above disorders.
This information is provided for general medical education purposes only. Please consult your
physician for diagnostic and treatment options of your specific medical condition.

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