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Diagnosis of Migraine & Headache Types

Migralepsy? Diagnosing Acephalgic Migraine with Aura, Seizure, Aphasia, Vertigo

  • By Wanderluster

    Hi all,

    My mom has had migraines for 40 years, the past 20 of which have been effectively treated (meaning they didn’t result in a seizure) with Sumatriptan until 4 months ago when they suddenly increased drastically in frequency and severity.

    Usually she experiences the classic migraine aura, takes the Sumatriptan, and goes to bed with a I-was-hit-by-a-Mack-truck hangover that lasts about 48 hours. No headache per se (just pressure), but drowsiness/sleepiness, nausea, numbness/tingling.

    But earlier this year she had 3 migraines in 5 days, two of which escalated to a seizure finally resulting in hospitalization. She had speech and motor control loss before/beginning of seizure (petit mal?) and aphasia (garbled speech) and memory loss before/during/after. EEG was normal. She was given Depakene and released after 2 days of observation. Had adverse reactions to the Depakene and stopped (approved by neurologist). Aphasia went away after 2 days, clarity and memory retention returned a couple days later, but episodic vertigo has persisted for months.

    In a few cases, before or after (or during?) the seizure she’s had episodes of something like sleepwalking where she isn’t conscious but her eyes are open and she insists on doing irrational things like removing the contents of the freezer and lying on the dining room table. She has no memory of this, doesn’t talk or respond to anyone, and her eyes are vacant. (This really freaked me out when I was younger!)

    Since the episodes a few months ago she has followed a strict anti-migraine diet and stayed off computer/phone/TV screens for the most part.

    But 5 days ago she had another aura, took a double dose of Sumatriptan (prescribed by doctor) and two hours later had a grand mal seizure, injuring herself (not seriously, thank goodness) by collapsing in the bathroom.

    She slept for the better part of 2 days, experienced only a short period of aphasia (less than a day) with increased vertigo and feelings of dread like she was going to die.

    Now, 5 days later, she is still experiencing nausea to the extent she can barely eat (diarrhea but no vomiting), numbness in the face and feet, and a general malaise that she associates with seizures from 20 years ago before she was prescribed Sumatriptan to prevent seizures.

    So we have a migraine with aura but without headache that lately has been followed by a grand mal seizure, aphasia, vertigo, nausea, and numbness.

    Is this Migralepsy? Has anyone experienced or seen a similar set of symptoms? Any insight would be greatly appreciated!

    -Wander

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  • By Nancy Harris Bonk Moderator

    Hi Wander,

    I’m sorry your mother is having a difficult time right now. I’ve not experienced similar symptoms, but hopefully others will be along shortly to share their experiences with you.

    I wish I could tell you exactly what’s going on with your mother, but only a qualified doctor can do that after she’s had a complete exam, discusses her medical history and symptoms. It may be time for your mother to seek out the expertise of a true migraine/headache expert, not just a neurologist, here’s why. A true migraine/headache expert is doctor who is board certified in headache medicine, which is different than being certified in neurology, and they may not even be a neurologist. It’s not that neurologists aren’t fine doctors, rather they have a hard time being experts on one area because they treat so many conditions such as multiple sclerosis, stroke, epilepsy, Parkinson’s and others. Let me share this information on how these experts are different and how to find one; http://migraine.com/blog/how-are-migraine-specialists-different/ and
    https://migraine.com/blog/really-find-headache-specialist/.

    We have information on migraine and epilepsy in this link that may be helpful as well; https://migraine.com/blog/migraine-and-seizures/.

    Please keep us posted on how your mother is doing,
    Nancy

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