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Ask Dr. D. Love Your Own Question
Dr. D. Love
Dr. D. Love, Doctor
Category: Neurology
Satisfied Customers: 18527
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I saw a neurologist today, and explained that my migraines

Customer Question

I saw a neurologist today, and explained that my migraines have changed over the years such as more numbness, more confusion. Lack of the ability to speak clearly and highly emotional. My mother and father both had them anti am on clonazapam and tops ax which helps. I've avoided a trip toner for shot for 8 years , but my mom had many and then meant strokes and died at 68. I had another this summer that lasted after the initial numbness, confusion, for 5 days. I have a headache almost severed some arecax19 on the severity scale. This dr was food , but something changed with how they operate. I'm concerned with TIA,s. I've had con concussions. Not severec, but with both parents history, I'm really thinkinkin more tearing needs to ne done. Someone who specializes in migraines and migralepsy. I was given a sgot, which I'm prou has been 8 years since I've needed. Bit the er dr said phenergan will help. He suggested I hollow up and suggested I see a neurologist. He gave me a prescription with no refills phenergan. I had a headache several days after and it with Tylenol, seemed to work. Advice?
Submitted: 11 months ago.
Category: Neurology
Customer: replied 11 months ago.
My deepest apologies for typos. I am lousy at devices. I miss typewriters ears and real keyboards with computers.
Customer: replied 11 months ago.
I do promise I am very well,educated but was writing on an iPad while hekpimg with homework. My deepest apologies for silly mistakes. I hope it's legible
Expert:  Dr. D. Love replied 11 months ago.

Hello from JustAnswer.

I could follow most of what you typed, but there are several aspects that are unclear.

Other then the shots that you do not need very often and the Phenergan, what medicines have been tried to help to stop the headaches when they happen?

How often do you have headaches?

Do you have any episodes of confusion or difficulty speaking when not associated with a migraine headache?

What did the Neurologist recommend at today's office visit?

Customer: replied 11 months ago.
Clonazapam
10x a month
So times but tell anyone can hide it easily
Botox topamAX. AND a dissolvable NSAIDsP
Cable
Botox and a strong NSAIDs after I yogg
Expert:  Dr. D. Love replied 11 months ago.

Thank you for the additional information.

There are several issues to discuss in this situation.

From the perspective of the migraine headaches, there are two general approaches to treatment.First is treatment that is done to stop the migraine headaches when they happen, also called abortive treatment. Second is the use of medicines to prevent the migraine headaches, also called prophylactic treatment.

You do not mention that you have been tried on a triptan. The triptans are frequently used to help abort a migraine headache and have the greatest success rate of medicines that are used for abortive treatment. Phenergan and chlorpromazine are also used, but have lower overall effectiveness. One of the limiting factors in the use of oral medicines for abortive treatment are side effects of the medicines or difficulty in tolerating oral medicines because of nausea and vomiting that frequently occur with migraine headaches. In people that have difficulty with pills for abortive treatment, there also is a newer technology available, called transcranial magnetic stimulation, which can be considered.

There are a number of different treatments that can be used for prophylactic treatment, including the Topamax and Botox recommended by your Neurologist. There are actually many other options, including beta-blockers, calcium antagonists, and certain antidepressants.

As for the risk for TIAs. It is true that migraine headaches, and particularly migraine with aura, increase the risk for stroke. However, identifying TIAs can be difficulty. Migraines can cause a variety of transient neurologic symptoms. It is also possible to have migraine-induced neurolpogic deficits without an actual migraine. If all of your episodes of confusion or difficulty speaking were associated with a migraine, that would be less worrisome. But if there are episodes of neurologic symptoms that are not associated with a migraine, that can be more difficult. If neurologic deficits occur both with and without a migraine, and the symptoms are similar, it is more likely that all of the neurologic symptoms are due to migraines rather than TIAs. But if there are neurologic symptoms that occur without migraine, that would be more worrisome, although it still could be due to migraines. In this situation, performing an evaluation for possible TIAs would be appropriate, such as a carotid ultrasound.

If I can provide any additional information, please let me know.