Sporadic Paralysis Attacks?

Ask the Clinician Health Guide July 28, 2008
  • Full Question:

    Sporadic Paralysis Attacks - Has ANYONE ever experienced this...?

     

    As I write this I am at the hospital with my wife (37 yr old, mother of 3 kids) that has had numerous (38 to date) attacks in the last month. Her symptoms include: loss of control in arms & legs (paralysis), speech problems, locking of jaw, weird eye & facial movement, etc. The attacks last approx. 10 min. and then she regains her muscle control. No real pains such as headache, etc. Feels fatigued after attacks.

     

    EEG, EKG, lab work, Scan, etc. have been ran multiple times....and they can't find anything. She was prescribed Topomax (100mg/per day) but that DID NOT HELP. She has been taken off the medicine and feels 100% better not being medicated, but the attacks continue.

     

    Could this be a Silent Migraine? What med's might help (besides Topamax)? Robert.
     

     

    Answer:

     

    Dear Robert,

     

    It is possible that what your wife is experiencing is the silent or acephalgic form of hemiplegic Migraine. Hemiplegic Migraine is the only form of Migraine that includes the symptoms of motor weakness and / or paralysis. See:

    That said, it would be quite unusual for the attacks to last only ten minutes or to have 38 of them in one month. Also, the locking jaw and eye and facial movement are possible with, but not common with Migraine.

     

    Topamax should be started at just 25 mg per day, adding 25 mg per week, with the dosage being split into two doses at the time of the increase to 50 mg per day. Starting it at a higher dosage or increasing it more quickly increases the chances of side effects and lessens the chances that the patient will tolerate the medication. It also takes up to three months of taking Topamax to give it a fair trial. See Dosage and Tapering Topamax for Migraine Prevention for more information.

     

    There are over 100 alternatives to Topamax for Migraine prevention. See Migraine preventive medications: too many options to give up! for more information and a listing of medications. However, before pursuing Migraine prevention, your wife needs a diagnosis. This is a good time to call in a Migraine and headache specialist. There's a link to our listing of patient recommended specialists below.

     

    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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    We hope you find this general medical and health information useful, but this Q & A is meant to support not replace the professional medical advice you receive from your doctor. For all personal medical and health matters, including decisions about diagnoses, medications and other treatment options, you should always consult your doctor. See full Disclaimer.

     

    © Teri Robert and J.C. Krusz, 2008.

    Last updated July 28, 2008.

     

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