Full Question:I have had a history of hemiplegic migraines. I suffered a cerebelar stroke on the left hemisphere from an injection of ergotamine in 1990. My family Dr. knowing my history gave me Imitrex, Axert and also Topamax. None of witch helped. The 1st two gave me stroke symptoms and I have read they should not be used for hemiplegic migraines. I had a stroke about a year ago and it happened after taking 1 Topamax. Can the Topamax cause this problem? Or is it as safe as I have heard? I was a right hemiplegic and I have regained gross motor movement, but fine motor is gone. I have several visual defects and some perceptual deficits. But I guess my question is about the medications. I think my Dr. should have had me on calcium channel blockers to keep the vessels relaxed and open. Do you agree? Dave.
Answer:
Dear Dave;Not knowing your medical history, including possible risk factors for strokes such as hypertension, increased cholesterol, increased triglycerides, smoking, weight status, etc., leaves me at a disadvantage. I agree that Imitrex and Axert should probably not be used given your history. I have never heard of Topamax causing a stroke, but anything is possible. My strongest advice is to seek out a Migraine expert given your more complicated history. And, perhaps, calcium channel blockers may be good choices. Keep reading, and never hesitate to ask your doctor questions about medications or other issues.
Good luck,
John Claude Krusz and Teri Robert
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