RARE AND EXTREME TYPES OF MIGRAINES
I have gone through several Neurologists in the past in abroad and out of 12 doctors who had examined me, one of them finally hit the dot. April 2013, I was diagnosed with a cross combination of Familial Hemiplegic Migraine or FHM and Sporadic Hemiplegic Migraine or SHM. Both are extreme and rare types that can cause temporary blindness, sudden confusion, memory loss, white spots, nausea, vomiting, paralysis (hemiparalysis) and numbness in one part of the body, just like the symptoms of a stroke. Migraine just doesn’t start with a severe headache, in my case it starts with folding of my fingers, up to my arms, down the numbness of the right part of my body from head to foot. I even suffered for memory loss for two years and until now presently which only occurs occasionally. It could last for hours or days, after that a severe headache from one side of the body will follow. It would only go away for a few hours after taking a painkiller and it will reoccur again after a few hours or even the next day. Hemiplegic Migraine According to Migrainetrust.org, hemiplegic migraine is referred to as a “migraine variant”. The word hemiplegic simply means paralysis on one side of the body. A person with hemiplegic migraine will experience a temporary weakness on one side of their body as part of their migraine attack. This can involve the face, arm or leg and be accompanied by numbness, or pins and needles. The person may experience speech difficulties, vision problems or confusion. This can be a frightening experience for the individual as these symptoms are similar to those of a stroke. This weakness may last from one hour to several days, but usually it goes within 24 hours. The head pain associated with migraine typically follows the weakness, but the headache may precede it or be absent. Types of Hemiplegic Migraine Familial Hemiplegic Migraine Familial hemiplegic migraine (FHM) is defined as migraine attacks occurring in two or more people in the same family who experience weakness on one side of the body as a symptom with their migraines. On average 50% of children who have a parent with hemiplegic migraine will develop this disorder. At least three different genes have been implicated in FHM. In half of the families where FHM occurs, a gene with a defect on chromosome 19 has been identified. This causes the related calcium channel to work incorrectly from time to time, and when it does a series of biochemical changes result in a migraine attack. For other families chromosome 1 is implicated which alters the behaviour of a channel involved in cell energy and in still others a sodium channel gene on chromosome 2 is altered. Even these do not account for all cases so more genetic causes will be found during future research. Sporadic Hemiplegic Migraine If someone experiences all the physical symptoms of FHM but doesn’t have a known familial connection they are diagnosed as having sporadic hemiplegic migraine (SHM). The cause of SHM is unknown, some are due to new or so called ‘sporadic’ gene mutations. Research has shown that people with SHM usually experience all four of the typical aura symptoms – visual, sensory, aphasic and motor symptoms – during their attacks. It was reported in the people who were studied that the motor weaknesses were always one sided and more often experienced in the upper limbs. For two thirds of people the symptoms lasted around an hour; whilst only 8% experienced this weakness for more than a day. None experienced the one sided weakness in their body without experiencing other symptoms as well, and the most common of these accompanying symptoms was visual disturbance. All experienced the headache of the migraine. What are the connections of Hemiplegic migraine to TIA and stroke? These three are all connected to each other as both TIA and stroke could start with a hemiplegic migraine so don’t take your headache for granted. There are various ‘triggers’ that can lead to a migraine attack. These vary and can be:
Types of migraines: · Migraine without aura · Migraine with aura · Migraine with typical aura · Migraine with brainstem aura · Hemiplegic migraine · Retinal migraine · Chronic migraine · Complications of migraine · Status migrainosus · Persistent aura without infarction · Migrainosus infarction · Migraine aura-triggered seizure · Probable migraine · Probable migraine without aura · Probable migraine with aura · Stress Migraine · Silent, or Acephalgic, Migraine · Sinus Migraine · Ocular Migraine · Seasonal Migraines · Cyclic Migraine Syndrome · Gastric Stasis Migraine · Tension Migraine Related: Hemiplegic Migraine VS Stroke A stroke happens when the blood supply to the brain is interrupted. This could be due to a blockage (called an ischaemic stroke) or due to bleeding in or around the brain (called a haemorrhagic stroke). The relationship between migraine and stroke is complex. You have a slightly higher risk of stroke if you have some types of migraine. Some of the symptoms of migraine and stroke can be confused with each other. How does migraine increase the risk of stroke? Occasionally, when someone has a migraine and experiences their usual aura, they do not recover as they usually would and it continues. A migrainous stroke may be diagnosed if, after a full investigation, a more likely cause cannot be found. The most common effect of a migrainous stroke most is a visual problem called homonymous hemianopia – where you can only see the right or the left side of the world out of each eye. This type of stroke rarely seems to cause other lasting severe disabilities and does not often happen again. It is not clear why migrainous stroke happens, but there are several changes during a migraine, which may be important. At the beginning of a migraine attack the blood vessels constrict (narrow) leading to reduced blood flow. This process can also cause changes in the blood, which cause clots to form. These, in turn, could cause a blockage in a narrowed blood vessel. Dehydration and vomiting during migraine can cause low blood volume, which also makes blood clots more likely to form. If you have other risk factors for stroke such as atherosclerosis (furring up of blood vessels) this could happen more easily. Strokes will not necessarily occur during a migraine attack. There are several possible reasons why having the condition migraine may increase the risk of stroke. These include migraines contributing to damaging the blood vessels, and migraines increasing the risk of fluid building up in the blood vessel walls (oedema) which can lead to the layers of the walls separating (dissection). This can lead to bleeding or clots forming in damaged blood vessels. There could also be underlying causes, which contribute to both stroke and migraine. Conditions which make your blood more likely to clot, such as systemic lupus erythematosus (SLE), Hughes’ syndrome and CADASIL are associated with migraine and with stroke. Migraine sufferers are also more likely than people who don’t experience migraines to have a patent foramen ovale (PFO) - a hole in the wall dividing the two sides of the heart. This may contribute to both stroke and migraine. How do I tell the difference between migraine and stroke? Some of the symptoms of migraine can be confused with stroke. Hemiplegic migraine in particular shares many of the signs of stroke. Migraine auras can be confused with transient ischemic attack (TIA) – where someone experiences the symptoms of stroke but they are temporary. Some people who have had migraine with aura get identical auras but without the headache. This can easily be mistaken for TIA. Hemiplegic Migraine VS TIA (Trans Ischemic Attack) According to Dr. James G. Marx from Las Vegas a specialist in pain management for 41 years, “A migraine's main feature is pain whereas a TIA is marked by loss of body function. Both are related to changes to circulation in the brain. Migraine may interfere with your ability to function but to a much more limited extent. Some types of migraine have more features of a TIA and need careful evaluation to determine that they are not symptoms of an impending stroke” While transient ischemic attack (TIA) is often labeled “mini-stroke,” it is more accurately characterized as a “warning stroke,” a warning you should take very seriously. TIA is caused by a clot; the only difference between a stroke and TIA is that with TIA the blockage is transient (temporary). TIA symptoms occur rapidly and last a relatively short time. Most TIAs last less than five minutes; the average is about a minute. When a TIA is over, it usually causes no permanent injury to the brain. TIA could be triggered due to a high level of emotional or physical stress, but this shouldn’t be taken lightly as this is already a warning sign of an impending stroke. The only difference of TIA to a hemiplegic migraine is that you don’t faint, stiffened to the point of being temporary paralyzed and your tongue rolls back. Symptoms of a TIA The symptoms of migraine and a TIA very similar. They all can cause changes in vision. However, in migraine headaches, the visual disturbances are dynamic and keep moving. Whereas with TIA the vision problems tend to remain static. Also, the migraine headaches symptoms typically come on gradually. With a TIA, the keyword is “sudden,” because the symptoms feel like they appear quickly. The symptoms of a TIA include:
Home remedy for both TIA/Migraine and Stroke: Though these are all emergency conditions, severity of its condition could be avoided if you will learn these procedures. Please note that this is only the first air remedy and not an alternative solution: Migraine: Painkillers help a lot to relieve the pain for temporarily, but it is even more dangerous to your liver to get used to high dosage of Ibuprofen and acetaminophen. · Put a hot towel or medicated gel bag (you can find this at the pharmacy) on top of your eyes covering your eyes, nose and forehead. Don’t get up; if you’re with someone ask them to do it for you. · Put the pillow at the back of your neck to support your nape, if your pillow is high, just roll the towel and put it under your nape. · Repeat the procedure three times, you will feel more relieved after 30mins. But even if you’re already feeling fine, don’t get up. Just continue sleeping, after the pain is gone, put a menthol liniment on both of your temples and forehead and nape. · Check the grade of your glasses and wear an eye protection like shades. · Drink a lot of ice cold water to relieve your dehydration · Avoid drinking caffeine or any diuretic element for the next three days TIA: There’s no certain warning when will it attack or when will it occur as even if you’re too sad or happy or elated, at anytime you would notice that your one side of the body or arm will start getting tingling and your fingers will start folding and stiffened. · When you feel like your arm is getting stiff and numb. Stop whatever you’re doing and thinking, breathe heavily in and out for three times as your heart and brain needs some oxygen. But don’t overdo it. If you have a digital blood pressure, take the BP monitor and take your latest BP. · Calm yourself down, if you’re sad, depressed or too happy. Just try control your emotions and be calm, don’t panic because it would otherwise worsen your situation · Massage your arm and neck and head · Don’t lie down on bed, just recline on a chair and put your feet up with a bag of ice on your nape Please note TIA and Stroke are very similar and it has the same indications of attacks. Stroke: A lot of people tend to panic when someone get a stroke. But there are two types of stroke, one is from the brain and one is from the heart. You could actually get a stroke without having a heart attack. Some strokes start with headache and fever with a fluctuating blood pressure. · If you’re feeling nauseous and your head seems heavy on one side, just sit down and rest for bit · Get a mirror and examine yourself if one side of your face is starting to loopside, when your one eye especially on the rightside is panning on a different direction · Put your feet up and put an ice bag in your nape and chest · If you have sugar tester needle pincher, take the immediate action of pinching the five fingers of the patient and let it bleed, the main cause of the stroke is blood clotting and nerve explosion. · Let it bleed and if the patient’s jaw isn’t stiff or tight yet, give them an appropriate medication such as isoket retard or aspirine. · When you noticed that patient’s way of talking, walking, feeling and responding is not normal, don’t take it lightly and act fast. · It’s much better if the blood would flow naturally from the fingers of the patient, if not keep on squeezing it and call the ambulance. · Don’t discharge from the hospital immediately, get an observation and please know that stroke could reoccur at anytime at a life threatening pace. Please note that these are only for the first aid procedure, situations like this needs a medical attention right away.
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