Guest author Alexander Mauskop, MD, is a migraine specialist and the director of the New York Headache Center. He is author of The Headache Alternative: A Neurologist's Guide to Drug-Free Relief, and What Your Doctor May Not Tell You About Migraines: The Breakthrough Program That Can Help End Your Pain.
Serene Branson, a TV reporter reporting live from the recent Grammys, suddenly began to speak gibberish. To most observers it appeared that she was having a stroke because stroke victims often develop aphasia — inability to speak or understand speech.
However, Branson was examined by Dr. Andrew Charles, a neurologist at UCLA, who established the true cause of her neurological problem. He attributed this brief episode of inability to speak to migraine. Branson has a life-long history of migraine headaches and had a headache at the time of this episode, according to Dr. Charles.
In addition to inability to speak, she developed numbness of the right side of her face. (The right side of the body and face are controlled by the left side of the brain, which is also responsible for speech.)
Approximately 20 percent of migraine patients experience a phenomenon called aura, which occurs 20 to 60 minutes prior to the onset of a headache or sometimes independently of the headache. The most common type of aura is visual. It consists of flashing lights, zigzags and other visual distortions.
A smaller number of patients develop sensory aura with numbness or tingling along one side of the face or body, which can occur after or before the visual aura, or by itself. These sensations often travel, starting in one hand, then moving up to the same side of the face.
Motor aura consists of weakness of one side of the body, which also precedes the headache and lasts 30 to 60 minutes. Motor aura is different from a rare condition called hemiplegic migraine, in which weakness is usually more severe and persists for several hours or longer.
It is not uncommon for people with migraine headaches to report feeling confused, or to having difficulty thinking and speaking prior to or during a migraine attack. When any of these symptoms accompany a headache for the first time or whenever they are more severe than usual, it could be a sign of a more serious condition, such as a stroke, ruptured aneurysm, or a brain tumor. The doctor will usually examine the patient and perform an MRI scan of the brain and blood tests. If all of the tests are normal, the diagnosis of migraine is established. Having a family history of similar attacks, helps to confirm the diagnosis.
If migraine attacks are infrequent, treatment is limited to treating individual attacks with drugs, such as sumatriptan. Some patients may respond to aspirin and similar medications, but many will require a prescription medication. If attacks are frequent, preventive measures can be effective. These include the usual recommendations for migraine sufferers, such as avoiding caffeine, exercising regularly, meditation or relaxation training, taking magnesium and other supplements.
If headaches occur on more than 15 days each month, Botox injections can help prevent headaches. Daily preventive medications, such as epilepsy drugs, antidepressants or blood pressure medications also help, but tend to have more side effects than other treatments.
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