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Confused episodes

by Vivienne N.
(Sacramento CA USA)

Child Migraine

Child Migraine

My 7 year old daughter has had 2 confused episodes in the last 6 months. She feels dizzy, strange, gets blurred vision,her pupils are much enlarged, she is confused, difficulty grasping objects and understanding instructions, nausea, fatigue. She suffers these for 4 to 5 hours. She falls asleep and wakes up normal but tired. She is completely back to normal mental speed after a few weeks.

We do not know what it is, we have been to see a Neurologist and he doesn't know if its seizures or migraines. We have done an MRI with and without contrast and a 24hr EEG- nothing,2 CAT scans showed a cyst which later was called a misread, the MRI did not show a cyst, after the most recent confused episode the Neurologist has ordered another MRI (more resolution this time) and another EEG for 3 day time period. If it is migraines or seizures what other scans and tests can we do to determine what it is for sure?

Answer:

Hi Vivienne,

From what you have described, your neurologist is on the right track. Sometimes with a new diagnosis of seizures..nothing shows up on tests unless a seizure is actually captured while EEG monitoring is done. Additionally with the 3 day EEG you might consider asking the doctor if it is available as a video monitored EEG.

At age 7, a diagnosis of migraine generally doesn't show much on the MRI and it sounds like she has had enough imaging done as far as that is concerned.

There is such a thing as confusional migraine in children, but you do not mention if her head hurts. With nausea and any abdominal pain, abdominal migraine or stomach migraines is also a possibility.

Keep working with the neurologist. If she has more episodes, the doctor may consider medication for awhile which will help the brain "settle" down so to speak.

Best of luck!
Mary Kay Betz MS RPA-C



COMMENTS:

My daughter is 7 now but, we've been dealing with all this since she was 2. She has been diagnosed with migraines, seizures, bipolar, ect. through her neurologist. All brain scans and so forth have been normal. You might talk to your neuro about possibly just trying a couple meds to see if they correct the problems. We tried Topamax first, HUGE LIFESAVER!!

Then we went and added Keppra, but, that didn't do well for us, so, we added Lamictal. It is fabulous and seizures and migraines with those meds combined with a dose of Vit B6 do wonders for my daughter. I'd love to talk with you about all this, email me!

ashlyrene2001 at yahoo dot com Good Luck.


Answer:
NOTE: edited for email to avoid spam. please do not post live emails.

Thanks,
Mary Kay

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Migraine and Depersonalization

by Jesse D
(Ontario, Canada)

Out Of Body

Out Of Body

Since June 2008 I have been suffering from silent migraines with moderate pain, tingling, and burning behind and around the eyes. Occasionally I'll see flashing lights and floaters, and experience some light headedness.

I've also been suffering from depersonalization which has been constant (with varying degrees of intensity) since the beginning of the migraines. I also suffer from sleep paralysis (usually one episode a week). What's strange is that when the migraine is gone, the depersonalization still remains. I haven't been on any medication for these, I've avoided painkillers because they don't solve the main problem: depersonalization. I would appreciate any advice you can give me. Thank you so much.

Answer:

Hi Jesse,

What you are describing is a constellation of symptoms associated with seizures, specifically partial seizures. There is approximately a 5% overlap between incidence of migraine and seizure. In other words, 5% of migraineurs have seizures and 5% of seizure patients have migraines. Migraineurs also have a high incidence of anxiety which can present as depersonalization, as do panic attacks.

Here is a description of simple seizures from the Epilepsy Foundation. Take a look and see if you have any of the other symptoms. If so you need to see a neurologist.

In Ontario, the University of Toronto and Western Hospital of Toronto have good neurology departments. You can also visit the NeuroTalk forum at Neurotalk and see if you can find a neurologist in your area.

Having said all this, don't be afraid of medications as we do use anti-seizure medications to treat migraine, so there is a good chance you may find that one medication will treat several problems.

I recommend that you see your physician as soon as possible for this.

Best of luck!

Mary Kay Betz MS RPA-C

Comments:

Thanks for the definition relating to seizures and migraine. I think my neice has this so I will tell her parents.




No problem..glad I could help.
Mary Kay

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Varying Symptoms

by Olivia
(Wisconsin)

Varying Headaches

Varying Headaches

Headaches have always been a sort of normal occurrance for me.

When I was in high school I would get dull headaches about once a week, which I always attributed to back problems (as a dancer I have overused and abused my back) or stress. But for about 2 years I've been getting headaches much more frequently.

I get these bouts of headaches. That last a little over a month, where I have pain in one part of my head for up to 10 min. and then the pain migrates somewhere else and so on for hours and then when the acute piercing pain is over I'm left with this duller pain that feels like pressure is being exuted outwards.

I feel the need to squeeze my head or wrap something around it tightly. They often make me slightly dizzy or disoriented. During this month I rarely go more than 24 hours without any head pain. But then abruptly those headaches are gone, often for months.

During the 'off period' I still get the overall pressure out kind of headaches. But the strange headaches feel like I was imagining them, until they come back.

Because I live a highly active lifestyle (full-time student studying biochem and working 2 jobs) doctors often brush me off saying to get sleep more and drink less caffeine, but these headaches don't seem that affected by these things. I'm often headache free during my most stressful periods. Should I go see a specialist? Do I need a doctor's referal for my insurance to cover such a visit.

Thanks for any insight you can offer.

Answer:

Hi Olivia,

If these headaches are that bothersome then yes, I would recommend you see someone. Start with your primary care physician as you need to be examined. Pay attention to any neck pain that is going on as that usually is what is influencing pain on the scalp.

You may have a form of cervicogenic headache that is causing the "dizziness".

The doctors do have a point. Irregular lifestyle is the most common cause of headaches. If you are not getting enough sleep, stressed out over school and drinking too much caffeine...well all this causes headache. It is sort of the brain's way of telling you to slow down and if you don't, the brain gives you pain to slow you down.

As to the referral, I can't comment as all insurance plans are different. Check with your plan and they will let you know.

Good luck!
Mary Kay Betz MS RPA-C

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