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Basilar artery migraines- June 2/07

I am curious as to whether I am getting migraines of this type. It is one of the more rare ones, so not likely. Still makes for an interesting post, there are types of migraines and types of treatment, always a good thing to keep in mind. I was originally diagnosed with transformed migraines, because of the changes in symptoms and varying intensity of attacks, as well as increasing frequency. Which makes a lot of sense when you consider the sleeping disorder I have. However, it does not make much sense when you consider the whole angina chest pain symptom or the loss of consciousness episode. Nor even some of the more profoundly neurological migraines I have had, since generally you are looking for a decrease in symptoms overall, not an increase in some and a randomness to others.

Basilar artery migraines:

"The neurological deficits accompanying BAM usually include partial or total greying or loss of vision, disturbances in oculomotor function (such as double vision), vertigo, tinnitus (ringing in the ears), ataxic gait (difficulty in walking), paralysis on one side of the body, altered consciousness (may include amnesia, confusion, stupor, and/or syncope (loss of consciousness)), ptosis (drooping eyelid, usually on one side of the body). and parasthesias (altered sensation and tingling) on one or both sides of the body.

In making a differential diagnosis for Basilar Artery Migraine, neurologists should look for the presence of two or more of the typical symptoms, which include vertigo, tinnitus, decreased or impaired hearing, ataxic gait, dysarthria, visual symptoms (normally in both eyes), diplopia, bilateral paresthesias or paresis, and impaired consciousness. These symptoms are usually, although not necessarily, followed by a throbbing headache in the occipital region (the back of the head). The vertigo that accompanies Basilar Artery Migraine normally lasts between 5 minutes and one hour."

So I do get,
-partial or total greying or loss of vision (kind of foggy vision which can be bad, and sometimes an aura that knocks out one eye completely.)
-double vision (This is a consistent symptom for me, with every migraine, although at times quite a bit worse than others.)
-vertigo (spinning head, feels like your moving when you are not, or so intense you can't even stand and it feels like you are spinning one way and the room the other)
-ataxic gait- if they mean walking into walls and door frames like a drunk then yes.
-altered consciousness- yes to intense confusion, and once I did faint.
-parasthesias- most definately, but I think this is a common migraine symptom
-decreased or imparied hearing- yep, mostly muffled hearing, the ringing or sensative hearing, or that cutting in and out of hearing.
-throbbing headache in the occipital region- my migraines do cause a lot of pain in that area, from throbbing to a spiking pain.

Now this type of migraine is a migraine with aura, so it is easily misdiagnosed. And also this type of migraine should not be treated with triptans... because it can cause a strong case of death, or stroke, heart attack or coma. And obviously I have had problems with triptans.

This would be speculation however. Just a little concerned about my treatment if I do have this type. Given botox should not be given to people with heart related issues. *drama alert* I would rather not get the whole death side effect to that. Whereas anti-seisure meds are fine, whether it is this type or not, and thus I would prefer to go on something that may help without causing a stroke or a heart attack. But that is just me; better safe than dead. It is a bit of concern, since the neuro who diagnosed my migraine type did not actually know much about complicated migraines. And given the increase in symptoms since then, some seriously freaky symptoms, I just wonder if he might have missed something. An MRI might have been a good idea.

Really I am just concerned over the angina, which is hardly something to ignore. While I do not get it as much now that I do not take Imitrex, it is still a symptom. Add that to this fainting episiode which was not looked at by my doctor, but she assures me it can happen with migraines, I am just a bit on the wary side. Fainting does not seem like something that regularly 'just happens' with a migraine. Not when you consider such things as possible seizure activity or heart related problems, and to simply brush it off without considering either of these does not sound like a great idea. Again, maybe that is just me.

My doctor is determined to send me for the botox, because well, she has no clue what to do with me. And I am pretty determined to try it, since this neuro has other suggestions to try if it does not work. So it is a moot point really. However, before I get the botox I am going to ask him to make sure it is a good idea in my case. But if I wake up dead a week after it, I will be so pissed.
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