Is It A Stroke Or Complex Migraine Headache Syndrome?
My husband sat by my bed in the stroke unit of the hospital last week, reading the literature the nurse had given him. Truly, we were both in shock. “You have less than a 1% chance of having a stroke,” he told me. Yet, that’s what the doctors were telling me I’d had. All the signs were pointing to it. I had experienced the telltale numbness in my left arm. A minute later it traveled to the left side of my face, which then felt like it was ‘melting’. For the next five minutes or so my entire system felt like it ‘shut down’, I wasn’t responding to stimuli; although my brain was working, albeit slowly. We made a mad rush to the hospital, where a stroke team surrounded me, initially diagnosing me as the victim of either a T.I.A. or a small stroke.
Me? Who tweets as ‘HealthyAuthor”? I’m 51 years old, with low blood pressure, and a resting pulse of 60. I exercise daily, practice yoga, and eat a mostly organic, vegetarian diet. Me, having a stroke?
My prognosis did look excellent. “Your heart, brain and arteries are all completely clear,” my doctor announced, after two days which included a battery of tests: a CAT scan, blood work, ultrasounds, an EEG and an MRI. Yet, on the third day, the symptoms of numbness and pressure on the left side of my face, as well as the slightest slurring of my speech, lingered.
This made the diagnosis of T.I.A. which had originally been given, troublesome. A T.I.A., or transient ischemic attack, is caused by a loss of blood flow without actual tissue death. It used to be referred to as a “mini-stroke,” but I learned that doctors no longer like to use that term. Unlike a stroke, symptoms of a T.I.A. will generally resolve within 24 hours and the MRI will show no evidence of a bleed. Because my MRI was clear, coupled with the fact that my symptoms persisted, the doctors were perplexed. They began to think that the MRI might have missed something, as it really only shows a sampling of the brain in slices; they were now switching back to the diagnosis of a small stroke.
A visit to an astute neurologist finally gave some direction. A second MRI was ordered, and if a bleed didn’t show up in that test, the diagnosis, by default, would become Complex Migraine Headache Syndrome.
Not someone prone to headaches — and this certainly didn’t feel anything like a headache — this neurologist had some explaining to do. Complex Migraine Headache Syndrome can mirror a stroke exactly, he said, and he himself has been fooled many times. The doctors in the hospital were correct to admit me and treat me as they did. From the left arm numbness to the speech difficulties I was still experiencing, it’s sometimes hard to differentiate the difference between the two, save from a positive MRI. The Complex Migraine could be brought on by extreme stress, which I had been experiencing, or, conversely, by a release of such stress. Interestingly, many people experience this type of headache on Saturday mornings just for that reason, he told me.
According to Harvard Medical School, “A “complex migraine” is one in which there are neurological symptoms such as weakness, loss of vision, or difficulty speaking in addition to the headache. In fact, a complex migraine may be mistaken for a stroke.
One theory about the cause of migraine headaches is that blood vessels in the brain suddenly narrow (or spasm) and then dilate; when the blood vessels dilate, the headache develops. During the spasm phase, certain parts of the brain may receive too little blood, and this may cause the stroke-like symptoms. However, unlike a stroke, blood flow is not permanently interrupted during migraine headaches, and the neurological symptoms are nearly always temporary.” (1)
Should this be the diagnosis, as opposed to stroke, I could go off the aspirin that my doctor put me on for life. There are medications to prevent this headache syndrome from occurring again. However, since I am a “naturalist” (as the doctor took my profession as a nutritionist to mean, I suppose!) he came back with a printed sheet of supplements that he advises his headache patients to use. I was glad for this approach, which he says he’s had success with.
What the neurologist advised:
Vitamin B-2 - 200 MG/2 times a day (also known as Riboflavin)
Magnesium - 500 MG Daily
Co Q-10 - 300 MG Daily
What I’d like to add to his regimen and why:
B Complex Supplement, in addition to the B-2 (Any B supplement should always be taken with a B complex)
Calcium - 1,000 MG Daily (Calcium should always be taken in a 2:1 ratio to Magnesium)
For now, I await a final diagnosis, hope for the best, and am thankful that all symptoms, whatever the cause, should be temporary.
1 - Complex Migraine. Harvard Health Publications Family Health Guide, Copyright © 2007 by President and Fellows of Harvard College. http://www.healthcentral.com/migraine/question-answer-27079-63.html