Full Question:
Family member started having these strange episodes. They started with tingling in the hands followed by general weakness throughout the body. Then they have difficulty concentrating, as well as, word retrieval difficulty. This period of about 10-20 minutes eventually leads to paralysis. They are unable to blink, speak or move their limbs. Breathing is fine and eyes dilate properly. They are alert and able to hear everything that is going on during this paralysis but are unaware of how much time passed while they were in this paralysis. This paralysis typically last for a minute or so at such time the process completely reverses itself. They are able to start blinking their eyes, then moving their limbs, concentration comes back and word retrieval starts to get easier. After the episode they feel physically drained as if they just ran a marathon. We went to the ER and had numerous tests done (see below) with no real diagnosis. These episodes came and went about every hour during the ER stay. The ER neurologist prescribed Gabapentin (diagnosis by exclusion - disturbance deep in the brain) and they were discharged. The medicine had an almost immediate impact with symptoms and severity decreasing. After a few days to a week all issues were gone and they didn't have another episode for three months. Note: They have never experienced this before and these episodes did not involve headache.
Following a heat wave they started to experience the symptoms again this time with a slight headache at the beginning and the end of the episode not during the actual paralysis. Additional symptoms included sensitivity to touch and smells. Another family member has history of migraines but not like this.
We have seen numerous neurologists and had the following tests performed Multiple EEGs, Brain CT, Spine CT, Brain PT, Brain MRI w and w/o contrast, EKG w/bubble, Carotid Artery and blood work. All tests negative. Can this be migraines? NDYRHLP.
Answer:
Dear NDYRHLP,
These symptoms could be attributable to hemiplegic Migraine. See Hemiplegic Migraine - The Basics for more information on this type of Migraine. Hemiplegic Migraine is the only form of Migraine that causes paralysis or motor weakness. However, nobody can diagnose via the Internet, so you do need to follow up for a diagnosis.
It's time to consult an actual Migraine and headache specialist. If you need assistance locating one, there's a link below to our directory of patient recommended specialists.
Good luck,
John Claude Krusz and Teri Robert
About Ask the Clinician:
Dr. Krusz is a recognized expert in the fields of headache and Migraine treatment and pain treatment. Each week, he and Lead Expert Teri Robert, team up to answer your questions about headaches and Migraines. You can read more about Dr. Krusz or more about Teri Robert.
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