Migraines w/o headaches... age? tests ordered?

Question: Migraines w/o headaches... age? tests ordered?

Answer:

Full Question:

For the last 8 years, I have been experiencing what I have recently come to believe is a migraine aura without headache. The first one started in high school, and I am now 26. These incidences occur about 3 times per year. Although I have experienced these for years, I never saw a doctor until the most recent one. The one that prompted a visit to my GP included the same sensations from before such as numbness in the hands, numbness in the cheeks, and visual disturbances. However, this one also caused half of my tongue to go numb, confusion such as not remembering names of friends, and I awoke in pile of drool after taking a nap. These symptoms encouraged the doctor visit. He referred me to a neurologist, whom I promptly visited. After I explained my symptoms, the neurologist was very surprised that I would be experiencing migraine without headache. She said typically it occurs in post-menopausal women and that she had never seen it in someone my age. She went on to order an MRI, and MRA, and an EEG. However, I am reluctant to undergo these tests, as they are quite expensive! Yet if there is a true cause for alarm, I will consider it. I would just like your opinion on the likelihood of someone my age experiencing migraine without headache and if I should relent to the testing. Thank you for your time. Melanie.

Answer:

Dear Melanie;

A Migraine attack can have up to four phases: prodrome, aura, headache, postdrome. Not all Migraineurs experience all the phases, and Migraine attacks can vary from time to time for Migraineurs. See:

Anatomy of a Migraine
When many people think “migraine” they think only of the pain of migraine. In reality, a migraine episode consists of far more. The typical migraine episode actually consists of four parts, referred to as phases or components.

That your neurologist hasn't seen a Migraine without headache in anyone your age may indicate that she's a general practice neurologist who treats a wide range of illnesses, diseases, and injuries, but doesn't treat a large number of Migraineurs. A Migraine specialist would tell you that Migraine attacks without headache can and do occur at any age, even in children.

As for the tests, none of them can confirm a diagnosis of Migraine, but are used to rule out other conditions such as tumor, stroke, aneurysm, etc. With your new symptoms of numbness of your tongue and the confusion, it's not surprising that at least an MRI would be ordered. If you're unsure of the necessity of all the tests, talk with your neurologist or even the doctor who referred you before having them done. You need to be comfortable with the doctor and tests ordered.

You might also want to come to our forum and discuss test with other Migraineurs. Sometimes, it's helpful to talk with others in similar situations. There's a link below to our forums.

Good luck,
Teri Robert and John Claude Krusz

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