Migraine With Neuro Symptoms

[mkoven]

So here I am again with a migraine. this one is clearly hormonal, as I'm 3 days b4 my period. I'd started trigger point injections that seem to help limit migraines at other times of the month, but my shot doctor thought that premenstrual migraines would not be eliminated with those injections. and here I am.

so here's the deal. You may remember that I was essentially fired by my neurologist last month. So I don't know who to check in with. I would just tough it out today, if it were just pain. But this migraine seems to have vertigo, numbness, and right-sided clumsiness associated with it. I've previously been told that some of my migraines are hemiplegic, and over a year ago had a full workup--cat scan, mri, mra, with no sign of stroke/tia. And this feels like ones I've had before. But I don't really know what to do when I have one of these scary migraines--just ride it out? It seems I don't really have anyone following my case right now, so I don't even know who to call? I don't want to go to the er, because I'm not even sure what they would/could do for me.

Anyone know if untreated hemiplegic migraines are dangerous? And how to treat them, if I'm not supposed to use triptans? Just cancel everything and turn out the lights???

[MightyMouse]

Not sure how to help, other than to say, I now get neuro symptoms with my migraines--the first one was around my period last month and really scared me b/c I had shooting pains running into my jaw. Have you ever been tried on DMG for migraines? It's a nasal spray, or you can go to the ER and get it as an injection--I have a friend who takes it at home via injection b/c the nasal spray doesn't work for her.

I don't know for certain, but I think it's not good to leave a migraine untreated--I think that migraines are supposedly caused by inflamation of blood vessels and I can't imagine that just leaving them in that state is a good long term solution.

Nina

[doctorguest]

Hi Michelle,

Sorry you're dealing with yet another migraine. These can be scary especially when accompanied by other neuro symptoms. Do you actually have weakness on the right side? True hemiplegic migraine involves weakness on one side that can be objectively noted by an examiner. If it's not hemiplegic, then the neuro symptoms are likely due to migraine without aura - that is if you didn't have these symptoms preceding the headache because if you did, it would actually constitute migraine with aura. Anyway, if you're getting even more confused by this, don't feel bad - the migraine classification system is not simple.

In terms of what to do, one option is to call your PCP. Some outpatient offices are equipped to administer IV meds in office so that you could avoid ER. There is also an option of an urgent care where you get IV meds. From what I recall, you have multiple allergies to medications, so perhaps experimenting with new medications at home at the time of an acute headache may not be the best option.

How many hours has it been with this headache? If it's migraine without aura, it's unlikely to cause any harm to you if left untreated, other than the discomfort of pain and suffering of course. If it's migraine with aura, and the aura itself is lasting more than 24 hours, then it's treated a little more aggressively than migraine without aura. It's reassuring that this type of headache is similar to what you've experienced before.

Anyway, this became longer than I intended, but I'd recommend if by tomorrow the headache is not gone, definitely call your PCP, just to be on the safe side. If the pain gets worse overnight, ER may be in order. Hope you feel better!

[mkoven]

Thanks, you guys. When this first happened a year ago, the examining docs did find I was slightly weaker on one side. It feels like clumsiness/loss of fine motor control. that part has subsided, but comes and goes, as does the dizziness. It is somewaht subtle, though. I'm not actually paralyzed.

I just took an ibuprofen. Not sure how I'll react given my recent reaction to naproxen, but I figured it was worth a try.

I also have some leftover dilaudid that I never take (prescribed to premedicate before a painful procedure), but I may try it tonight to see if I can get some sleep. My memory of dilaudid is that it packs a power ful punch, but is very short-acting. Maybe it will be enough to fall asleep. I hope I don't wake up with this thing. I have a full day at work tomorrow.

This is getting really old. I was hoping the trigger point injections would help, but I guess hormones take the day. I don't normally fantasize about menopause, but today I do.

[mkoven]

It was a long and unpleasant night, but I finally got some sleep, and the headache has pretty much subsided--with a combo of ibuprofen, dilaudid, and some sleep. I'm feeling a little traumatized by the whole thing. These premenstrual and menstrual headaches are really brutal and frightening. Thanks to Nina and Doctorguest for your support and input.

[ajw4790]

Hi!

I am glad it started to feel better! I was just a little concerned on the just taking the Dilaudid that was prescribed for something else. Also, I am not sure is that often used for migraines etc. I guess I probaly just haven't heard of it! Anyways, just be careful taking meds not how they were prescribed, especially such a strong pain killer. Guess it just worries me! But glad it worked!!!

Why no triptans? Just curious, if not supposed to use for some migraines?

Good luck!!!

[mkoven]

Hi,

A doctor very reluctantly prescribed triptans for me, because I've reacted so badly to so many meds , and because I believe they are contraindicated with hemiplegic migraines. I haven't tried it yet. I'm always afraid to try a new drug for the first time, esp after business hours. I've ended up in the er multiple times this way...

I wasn't thrilled about taking the dilaudid, but I know I tolerate it okay, and wouldn't end up in the er. (The neurologist had actually offered me vicodin, but I'm allergic. ) I'm not someone who would ever take painkillers, if not in pain, so I'm not concerned about getting hooked. I've had this nearly full bottle since march.

But yes, it would be good to have a dedicated migraine doctor and migraine plan. My last neurologist dumped me for being too complicated, and this is a small town without a lot of neurologists. So I'm looking.

[ajw4790]

mkoven,

Hi! Thanks for the info. on triptans! That is awful about your neurologists, and I wish you the best of luck with finding a new one! I didn't mean anything by the med thing, it was obvious you hadn't been taking it a lot b/c you still had some from before. I just get nervous when people take meds as they weren't prescribed. I guess it is just those horror stories kicking in!

Good luck!