Friday, August 15, 2008 Leah Pitman asks

Q: ANY HELP? COMPLICATED MIGRAINE? STROKE LIKE NEUROLOGICAL SLURRED SPEECH EVERYTHING SLOW

Please help me. As a child I had migraines, one side of head, always vomited, slept them off. As I began having periods I noticed a drastic reduction in frequency of the headaches. At age 21 I had an aura, (never noticed that before with previous migraines)( saw dots ) before the onset of pain. It was a very bad headache and I feared they were going to start coming back. They did not and I have been migraine free for 28 years. Headaches, of course, but certainly not the migraine type!

I am now 50 and have been without a period for over a year now. I have been put on some progesterone for hot flashes, as I have been afraid of estrogen because of family breast cancer. The hot flashes have diminished some what but they are still troublesome

just not as severe or frequent.

I began having strange symptoms recently that were bothersome with a gradual onset. My speech began to slur and I staggered when I walked as well as having trouble coming up with the words I needed. I had the feeling that I just took strong muscle relaxers and everything was in slow motion. This lasted about an hour and although I was bothered by the experience, I did not contact my doctor. I went weeks without another one, but over the last few weeks began experiencing more, although not as severe as the first one. The thought crossed my mind about TIA's but my sensations do not affect only one side of my body, but both sides equally.

I had an episode tuesday that did scare me enough to get me to the emergency room. Of course they suspected TIA's or stroke and proceeded with the standard tests, CAT, MRI, EKG, EEG, echo cardiogram, and bloodwork. I was assigned an internal medicine doctor as well as a neurologist. When all the above tests came back clean, the neurologist decided my symptoms were Panic Attacks and prescribed Xanax 3 x per day. I refused the drug.

The next day I had another attack in the hospital, and when I called the nurse, she assumed I was having a panic attack. I could not even believe this, as I was not under any unusual stress, and I was upset that just because they ruled out stroke they assumed the Panic attack diagnosis. The attack while in the hospital lasted about an hour and I returned to my normal self. That evening I developed a headache that I assumed was due to lack of sleep and the uncomfortable position my neck was in while in the MRI. The headache progressively got worse and was on one side of my head and light began to bother me and I got nauseated. I knew the feeling, it was a migraine and I had not had one in so long! It peaked and lasted about 4 hours and gradually went away before I even went to sleep. Im thinking, I wonder if the migraine could be related to these weird symptoms. I called a few friends with access to computer and had them look some things up and was amazed that migraines could cause neurological symptoms that mimic TIA's. I told the doctor the next day that I knew what I had, and that it has nothing to do with panic attacks. That day I did have some slight symptoms another

episode only involving slightly slurred speech and numbness around lips and face. Didn't last very long. I asked the nurse to take my bloodpressure and the bottom number was 65 which was much lower than normal for me.

I was frustrated because on the form I filled out at admittance when answering all the health history questions, I did check migraines in my history and the Doctor never even suggested the possibility, just jumped to the conclusion that I must be panicing! Today, Friday, I had no symptoms at all, and they released me from the hospital, with both doctors agreeing with my diagnosis of it being related to migraine.

My main question and concern I have is that I still don't seem to have the classic symptoms of a migraine aura according what little I have read since coming home from the hospital.

My symptoms do not only affect one side of my body, but both equally. My headache was however only on one side. I have had no visual disturbances with these. I do have trouble with slurred speech, and coming up with words. Everything slows down like you would feel after taking several soma at once. The symptoms seem to peak and then gradually disappear. Are my symptoms just rare but seen, or should I continue to seek answers for my strange episodes? I also have fibromyalgia that I take 30 mg elavil at night for. Thank you for your time and expertise. Leah

Answers (4)

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Teri Robert

8/18/08 2:21am

Leah,

Wow, what an ordeal!

The bottom line is that you absolutely need a diagnosis and appropriate treatment. Whiel your symptoms do sound like Migraine, they could also be stroke, TIA, or any number of other issues. If they didn't run an MRA and MRV in the hospital, that may need to be done to fully rule out stroke and TIA. If this does turn out to be Migraine, there are treatments that can help.

If your doctors aren't coming up with any answers, I suggest you see a Migraine specialist. If you need help locating one our directory of Patient Recommended Specialists should be helpful.

I wish there were more we could do for you, but the first step is getting a diagnosis.

Good luck,

Teri

3/13/09 3:04pm

You are not crazy! I just got out of the hospital yesterday. Started on a hormone patch on March 10 (lowest dose available). After two weeks, I was in the grocery store and started having visual disturbances. Barely got home and got in bed. Knew something was terribly wrong and sat up and tried to say something out loud to myself. (My husband was at work.) Everything I tried to say out loud came out garbled. I freaked out. I've never had a migraine headache. I managed to call my friend and next-door-neighbor, who came over immediately. By the time she got there, I could not communicate with her. Every time I tried to ask her to help me, the words came out garbled and nonsensical. She is an R.N. and immediately called 911. I could not communicate with the paramadics, either, except to point when they asked me where my medications were, etc. Unfortunately, I wasn't even thinking about the patch on my abdomen. I was in the E.R. a couple of hours before a doctor came and took the patch off. All together, I was unable to verbally communicate for approx. 2 hours. It was absolutely terrifying. I thought I was having a stroke. Evidently, the doctors did, too, because they did numerous tests, including MRI, MRA, CT scan, carotid sonogram, heart sonogram, EKG, bloodwork, all sorts of tests. Four different physical therapists came and saw me. By this time, I was pretty much back to normal but scared to death about what had happened. After two days in the hospital and several doctors conferring, they said they thought I might have had a TIA (transient ischemic attack) or a "mini-stroke." But I was at very low risk, so they weren't sure. Then, on the third day, after reviewing all my tests, which were all good, the head neurologist said he still wasn't sure, but he believed I had some sort of "migraine event" triggered by the hormone patch. The estrogen patch was the suspected culprit all along, even when they thought it was a TIA, since they said it could have caused my blood to coagulate and trigger an attack. I have been home since yesterday and am waiting for the neurologist's office to return my call. So I think you should discontinue those hormones until you find out for sure from a specialist! I hope you do well!

toni_s

6/14/10 9:28pm

Has anyone suggested you might have a PFO (Patent Foramen Ovale)? They can cause Complicated Migraines that present as strokes. I have been dealing with this for four years now, and am going to find out if I have a PFO tomorrow. Look into it- It was my heart after all.

familyof5

7/24/10 2:14pm

I too have extreme migraines, issues with my speech slurring and some facial Ball's Palsy at times. I don't always have a headache when my speech slurs or get the facial numbing. I was diagnosed with Benign Intracranial Hypertension. which was diagnosed after alumpar puncture to check my fluid pressure. I saw a neurologist who sent me to have MRI, TEE, ECG, and I also saw an endorinologist and neuro-optomologist before being diagnosed. It took a little over a year and it has been frightening. I didn't believe the diagnosis the first time. I was diagnosed 2 years ago; was off medication and had no symptoms for about a year and a 1/2 and now it's all back worse than before.

KMAC

1/25/12 11:08am

I to was diagnosed with idiopathic benign intercranial hypertension by having bilateral optic neuritis and a high opening pressure for lumbar puncture. I was hospitalized for 9 days with multiple tests, imaging, and lab work. I had every symptom in the book for ms, even not being able to walk. This was back in Oct. 2006. I went to different drs from rheumatologist, endocrinologist, neurologists, cardiologist, vein specialists, neurologist, etc. I even had psychological testing done to see if it was mental related. I had drs believe it was all in my head, that I was crazy or had conversion disorder. It was more depressing than you can imagine. It caused marital problems, lost friends, and even my own family thought I was all due to stress. I ended up having such severe tremors I could not function and one neurologist informed me in a nasty tone when I asked him to help me cuz I could not live this way with trying to take care of a 3 yr old and 6 yr old with a angry husband that works 60 plus hrs a week that "I dont have a magic pill to help you, I think you need counseling that this is a mental issue." needless to say I never saw him again and left his office in worse shape due to crying and being so extremely upset. I ended up seeing a different neuro who has followed me through everything since April 2007 with IBIH also called pseudo tumor cerebri. He has been watching for possible ms which could take years for brain lesions to occur, and has diagnosed my symptoms that are just like ms with left sided facial droop during attacks (it is not bells palsy) and to weak to walk, severe speech slurring, no thought process right sided severe weakness etc with complex migraines or some call it complicated migraines. Most of the time I have no head pain or actual migraine which made it complicated to diagnose with no head pain. It wasn't until last year after dealing with this for over 4 yrs that I actually started having excruciating migraines in temple above eye and sometimes behind the eye. With complex migraines which is what yours sounds like you can have no actual migraine but severe and very debilitating neurological symptoms which are very scary. I personally own a walker, cane and wheelchair for when my attach is severe. It is NOT in your head and you are NOT crazy, so do not let people tell you that you are. Always stand up for yourself and you are your best advocate. If you feel in your heart something is wrong or not right, get it checked out and go to what ever doctors you have to, to get your answer that you feel is correct and fits. Not all drs are aware of every condition, and not all drs will work with you to find your answer. Best of luck and prayers for answers, cures, and hope. BELIEVE IN YOURSELF!

Q: ANY HELP? COMPLICATED MIGRAINE? STROKE LIKE NEUROLOGICAL SLURRED SPEECH EVERYTHING SLOW

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