What Causes a Complicated Migraine?
by Anna Hart
Filed under Causes of Migraine Headaches, Featured Content
Migraine comes in a variety of shapes and sizes, all similar, yet all unique. Many migraines are first noticed with the aura: visual and hearing disturbance, nausea, and vomiting are all part of the aura. When the aura ends, a dull ache signals the beginning headache. Most migraines go on to develop into a throbbing, excruciating pain at the temples, front, or back of the head.
The complicated migraine is different.
Define Complicated Migraine
A complicated migraine has the disturbances of an aura, but the symptoms are prolonged, often lasting into or through the headache phase itself. Whereas a common migraine’s aura is done in 20 minutes to an hour, it continues with a complicated migraine, sometimes lasting throughout the hours or days of pain.
Four Forms of Complicated Migraine
Complicated migraine has four forms.
1. Basilar migraine: A typical migraine aura progresses to developing neurological symptoms related to the brainstem. Affecting both sides, the headaches of this migraine are often at the back of the head, and may cause severe vomiting.
2. Hemiplegic migraine: Quite possibly inherited, this migraine causes stroke-like symptoms with loss of muscle strength and/or sensory loss.
3. Ophthalmoplegic migraine: This migraine causes partial or complete paralysis of the nerves needed for eye movement.
4. Retinal migraine: Visual symptoms come from the retina itself rather than from the portion of the brain involved in vision.
In all of these forms, complicated migraine seems to carry an increased risk of permanent neurological changes.
Causes of Complicated Migraine
The causes of complicated migraine are not clearly understood. In some cases, they are believed to begin with a spasm, or partial closing, of arteries leading to the brain. The spasm decreases blood supply to part of the brain, causing the aura. The arteries then relax too much, giving a surge of blood, which causes pain. This artery action involves dopamine and serotonin, chemicals normally found in the brain, but when in abnormal amounts, able to cause blood vessels to act in uncharacteristic ways.
Triggers of Complicated Migraine
Various triggers also are thought to initiate complicated migraine. Different people may have different triggers.
* Certain foods such as alcohol, cheese, chocolate, and monosodium glutamate (MSG. (MSG is a flavor enhancer used in many foods, including Chinese.)
* Contraceptives (birth control pills)
* Missing a meal
* Sleep pattern interruption
* Smoking
* Stress and tension.
Genetic Disposition to Complicated Migraine
All migraines are thought to run in families. Some, like the hemiplegic migraine, have been linked to chromosomes.
What to Do
If you think you may have complicated migraine, see your health care provider immediately. This migraine is severe and can cause long-lasting neurological changes in the brain. Your physician may want to begin treatments to prevent future episodes rather than treat them after they have begun.
About a week ago, I developed a tic in my right eye. This was accompanied by a bad head ache that was lingering for days. I finally had enough of trying to control it with, tylenol and made an appointment with my doctor after the right side of my face went numb and looked as if it was moving on its own. They examined me and said my symptoms seemed to discribe a migraine and gave me a shot and sent me home. When I asked when my face would stop twitching, they had no answer. The next morning, when I woke up the headache was better, but still there in the back of my head. I went to work and about noon, lost motor functions in my face and my right arm and felt disoriented. Startling my co-workers, they got me to the emergency room, fearing stroke. After spending the night and several tests, CAT, MRI and blood, was told everything was normal. And that I had had what is termed a Complicated Migraine. Its has now been over a week since the headache started and it is still there. I also still have the twitching in my face and my muscles still pull occasionally. I had a gastric bypass 18 months ago so am limited as to what I can take for this. Any help or feedback would be welcome. But just knowing I am not the only one who this has happened too has made me feel like less of a freak.
Hello,
I like so many others have had marginal medical after a Complicated Migraine. Mine started June 2005, and my first episode was the worst. Within minutes of getting home late one night, I had lost speech control, all motor function and was completely numb in my face, arms and legs. I could no longer sit, stand or tell anyone what was happening. My friend knew that something was wrong and drove me to the ER. I had passed out by this time and he got me into the hospital. I have no memory of what happened next. He told me that the nurses thought that I was on drugs and shrugged me off until he yelled and screamed at them to check me out. I was put under every test they could think of, including a MRI, CAT scan, pregnancy test- everything. By this time my parents were there and I could not even speak my own name- I had forgotten it. I began to throw up heavily, and continued to black out. This was when the pain started. This went on throughout the rest of the night and into the morning. I was sent home and was told to come back in when the next one started.
They did not have to wait long! That whole summer I ended up having a total of 27 attacks. It was labeled as a TIA by one hospital- and they never gave me anything to control it or to prevent another attack, so we switched doctors. My attack symptoms were varied after the first attack and began to get serious. I do not remember these but I was told that I had tried to walk through a glass door, hit my mother, and successfully moved and entire dresser across the room. I could by this time tell when they were coming on. My attacks could last anywhere from 6 hours till 10 or 11 hours, but I could never tell how bad they were going to get.
Finally, I was taken into a Child Neurologist, and he put me on Beta Blockers and a trial pack of some new drugs to control the onset of another attack. I was taken off the label of TIA, and now was diagnosed with having a Complex Migraine.
Then one day they just stopped. And since then I have had no symptoms or any headaches at all. I never changed any of my habits and I was actually put back onto my birth control pill- which was thought to have been the cause. I did have a lower dosage, but for 3 years I was clear.
Until yesterday. I had another attack and I knew the instant I started to feel weakness in my legs and arms, I knew what was going to happen. Sure enough, My symptoms lasted from 11:30 in the morning until 7:30 that night.
Today, I am headed to the Child Neurologist to get my medical records and take them to the Military Medical Center to see if I am able to try something else. I am hoping that this blog will help others recognize their own symptoms and try to get some help. It is my resolve not to be afraid to drive, be home alone, or mainly have a normal life and letting these attacks rule my life. This condition is very misunderstood and is commonly referred to as a TIA. Find a doctor that has experience with Complicated Migraines and get some help. This is not a way to live your life.
I was just diagnosed with complicated migraine 4 days ago in the hospital.My diagnosis changed from TIA to this.I am scheduled for a spinal tap to R/o MS.I still have symtoms of dullness on r side of cheek and eye.I dont know how long this will last i am very scared it will turn into something else.My ct has a lesion with multiple smaller spots through-out doctors say i am too old for MS and too young for TIA I am 48.
Hey all, your stories are all too familiar. I have had complicated migraines for over twelve years. I usually get an attack every two years. I have different type symptoms with each attack, but they have all started with a horrible migraine followed by severe fatigue. My attacks seem to last several months, and can be triggered by doing to much, the heat or stress. I am in a mild attack right now and I am trying to rest as much as possible so it doesn’t get really bad that just getting in the shower in the morning will wear me out so bad all I want to do is go back to bed and lay down. I also have tingling, numbness and can’t think straight. For years they thought i had ms, but it would never come up on the mri’s so they settled for complicated migraines I hope they can find better ways to treat and control these type migraines.
Gina – you need a neurologist who really understands MS, TIA’s, Stroke AND Migraines. Do not allow anyone to rule out MS. I was diagnosed with MS about 7 years ago — at 52… As newer and better methods of diagnosis have come along, there are many neurologists who realize that MS can show up at later ages than previously thought.
Also be aware of a couple more things — Spinal Taps and MRI’s do not always show everything. A Spinal Tap will ONLY show up with MS if you are in the middle of an active attack. Most MS cases are of the Relapsing Remitting type — this means that it is on-again, off-again type if disease. MRI’s can’t see everything – including lesions that are too small to show up yet, but may be effecting very important nerves!
If there is an MS Center anywhere near where you live, I would highly recommend getting a referral there! Because the good thing is that my MS has progressed very little in the 7 years since it was diagnosed! There are very good meds available now that are wonder drugs in my opinion!
I am still recoving from my first complicated Migraine attack about 5 days ago. There is just “residue” left at this point and I hope to be feeling really good soon! I am fortunate — I have a very pro-active doctor who will not rest until answers are found. In my search for my MS Diagnosis, I found that keeping a journal both helped me and also helped my doctor in arriving at his diagnosis.
Good luck to all of you – I am still reading and learning about these stupid bloody migraines! For more information on MS, check out the information at http://www.nationalmssociety.org/index.aspx — I know it really helped me!!
Portia
Hi, im only 13 years old and suffer from complicated migraines. They started when i was about nine years old. I don’t know what causes them and neither does my doctors.
The First one i got i was tumbling. I started to get a real bad feeling in my stomache. I stopped, drank water, and feel asleep. I woke up one hour later with a pounding headache!! I didn’t know what to do, so i went back to sleep and woke up the next day and i was fine.
The second complicated migrain i had was a few summers ago. I was at my babysitters house. After i had eaten breakfast i started noticing that my eyes would go blury, i shut my eyes and when i would open them it was fine for a few minutes then went back to being blury. I laid down for awhile, and then started noticing other sympotms. The i started getting a pounding headache on the right side of my head. Then my left arm felt heavy, whenever i would lift it, it would go back down i couldnt keep it up. I decided to call my mom, when i called her i couldnt get my words out. I knew what i wanted to say but i couldnt think of the word. It was really odd. My came and took me to the hospital. Every noise i heard sounded like a big boom and i was sensitive to every light. When i got to the hospital i started vomiting. The doctors took me in for a cat scan. The results came back normal. The dotor said i was suffering from complicated migraines with stroke like sympotms. The nurse gave me some advil and sent me on my way. When i came home i just slept, and woke up fine.
The latest migraine i suffered from was Monday July, 27th. I was at cheerleading practice and the coaches had worked my team very hard. i was fine all through practice and then again my eyes started going blury, and i was developing a headache on the right side if my head. My left arm, and hand started going numb and strangely so did my tongue. I kind of already knew what to expect so i put ice on my head and a heating pad on my neck to relax my muscles. I slept and woke up with still a slight headache but nothing to serious.
My mom has made an appointment for me to visit the doctor on Aug 6, to see if i can get a certain medicine to make my outburst less painful.
If you have an information on complicated migraines please let me know.
Thanks,
Savannah
I am so thankful for everybody’s input and wisdom here. I may have a unique situation here but I can relate to all of you. (Then again, we are all unique, aren’t we?) I was what everybody would have considered a very healthy individual with some minor migraines from time to time. I had the occular migraines with the aura resulting in headaches, but nothing so severe I would vomit or be terribly affected by the light. Last December I was sleeping and had a grand-mal seizure followed by 7 others. I had brain surgery within 8 hours or so of my first seizure because they found an abcess on my brain in my vision center. Shortly after in a follow-up visit they found a PFO or hole in my heart which they believed was the cause of the infection in the brain. I ended up having heart surgery in May. All was fine and well…I went off the seizure meds and felt great. Then middle of July I was doing yard work when my right side went both numb and tingly all over. I tried to tell my friend what was wrong but I couldn’t form my words. It was terrible. I knew my thoughts and I knew what was going on; I never fell, I walked to a bench to sit and even contimplated spelling things out in our garden rocks but within a few minutes my speech was back and the numbness/tingling was gone. Shortly after I had a occular migraine on my way to the ER. Lots of tests later and being told everything looked fine a neurologist told me he thought it was a complicated migraine where another neurologist told me he thought it was a focus seizure. I still don’t know what it was for sure. I still have residual tingling in my hands. They tried me on one migrain/seizure medication combo pill but I became so “stupid” on it that I stopped it. I was also put back on my ‘old’ seizure medication but even that had long-term negative side effects. I am scared of this happening again. I have two young boys. I pray that the good Lord can put some amazing doctors out there who will better understand this and provide help for all of us out there who just want to walk each day in peace without the fear of something happening to our bodies. What kind of migraine meds are you taking out there and how are they working for you? Anybody on seizure meds too? I’m currently on Dilantin but hoping to find a newer school of medication to take soon that won’t give me negative side effects. My wish would be to be medication-free. My prayer is that my children don’t have to experience this too. Blessings to everybody out there hoping for answers too.
Hi Savannah! I have almost the same thing! I’ve had chronic daily headaches since I was 8, and have been getting bad migraines since I was 15 (I’m 16 now). My first complicated migraine was some time in August of 2008, and it woke me up from my sleep, I was blind and saw double for a little bit, and then my left arm went numb and then my lips and tongue and face went numb and tingly too! And of course I got a really intense headache, and throbbing on the right side of my head. I was stuck in the hospital for a week and no matter what they gave me nothing helped, and I’ve been having migraine issues (on top of my normal headaches) ever since. I had another complicated migraine last Thursday (after many many regular migraines before that), the barometric pressure was really high and it woke me up again and I had major blind spots and then a terrible headache. And I just got yet another one on Tuesday! It was the most intense yet, my left arm and my right hand and my lips and tongue got so numb and tingly again and I got a terrible headache. So I guess my point is, I get them too! One of my doctors thinks they’re caused because my blood vessels don’t constrict/dialate correctly and because my autonomic nervous system doesn’t really work right (so the blood doesn’t flow right and some neurotransmitters either have too much or too little effect), but we haven’t found anything to treat them yet. A cold cloth on my forehead and sometimes vasoconstrictors work to take the edge off, or something that lets me sleep until it gets a bit better. I hope you (and everyone else) can find something that helps!!
Hello,
I was wondering if anyone has ever heard or known if severe shaking can also be a symptom of these complicated migraines? About two and a half weeks ago my husband started with these episodes. The first one he woke up, felt numb and started shaking uncontrollably. It got progressively worse and we went to the ER where they gave him some IVs and thought is was a drug interaction reaction. A few days later he got a hot feeling through his body and started feeling faint with chest pains, again he went to the hospital but every test came back fine. Then a few days later he had another episode where he got the hot feeling through his body and he started to shake again. This time though he couldn’t formulate words. At the ER he was fighting to gert words out and he couldn’t move his arms and legs. His left side was weaker than the right side. After an hour or so it passed. He still has tingling through his body and doesn’t feel right and he did have a migraine headache yesterday. He has had MRI of brain, spine, EEG, EKG, Echocardiogram and tons of bloodtests and everything is coming back normal. From reading about complicated migraines it sounds like it could be that but am wondering about the shaking. I am also curious as to why the neurologist didn’t bring this up as a possibility?
My son is 17 years old. The last few years he has had these same stroke like symptoms (ie: numbness to his tongue, hand tinglings, blurry vision, weakness usually to one side of his body). He complains of pain to one side of his head. Shortly after the pain he starts throwing up. The first time this happened we took him to the ER and they ran every test there is! The sent him to a childrens hosptital in LA. They ran more test. The pediatric neurologist told us he has complicated migraines. We were told to give him advil on the onset of the headache and medicine for throwing up. The second one he had about a year later, didn’t seem to get any better even with advil and medicine for the throwing up. So, we ended up at the ER again. I told them about the diagnoses of complicated migraines but, they still test him for drugs. Friday night (about a year after the second headache) he came home with a all his symptoms of a complicated headache. There needs to be some treatment for these headached BEFORE someone has to go through these headaches.
my name is betty, i woke up may 5, and my right should was dropping, i did’nt feel to goo, i went to work, my head was hurting some but not like a migrane, later that night my right side of my face started twitching, i had my husband to take me to the er, when i got out of the car, i could not stand or walk, a security guard, helped me into the hospital while he parked the car, my b/p was high, they kept me at the hospital, and ran a lot test, mri, ct scan, coriard artiy ultra sound, and a lot of blood work, they first said it was a t.i. a. then after i got go home they said that i had complicated migrane, will my shoulder ever get back to normal, and should i talked to my dr more about this. could you email me with some information what to expect, this is the first complicated migraine i have ever had, i have had several t.i.a’s. before, and i beleive it was a t.i.a,
thank you
betty
email bgray330@nexband.com
Hi,
I’m really happy to have found you guys. I have been having the same symtoms since March. I have had MRI,EKG,Stress Test,Blood Work you name it I’ve had it. They told me I was having symtoms of stroke and heart attack. I went to every doctors even a second opinion. The last doctor was today i saw a neurologist he said I know whats wrong with you you have something called Complicated Migraines. I never heard of it. I too have numbness in my face i kept thinking I had a toothache. I have tingling in my had and arms on the left side. I have blurry vision and sometimes its hard for me to see. I was at Target on tuesday and was rushing to get back to the line after forgetting something. I got dizzy and the room started spinning I grabbed hold to the basket for about 10 minutes. I then start to have a real bad headache it was pounding. I went to the line and paid for my stuff as fast as I could. I went home and the headache lasted the rest of the night. I was told I had a TIA two yrs ago I believe it was the samething I’m having now. All my test came back normal two yrs ago and now. This is a very scary thing because you never know when the dizziness and lightheaded is going to happen. I’m just glad I’ve finally found out what it is. I have been going back and forth to the doctor and hospital for two months. I can now take it to GOD! I’ll pray for everyone
Thanks for listening
Carol
Back in January 2010 I was at work and my whole left side went numb and had a severe headache, and was like that for close to 2 hours by the time I got home, I called my family doctor and they sent me to the ER. well after testing nothing came back abnormal, so they suggested I go see a Neurologist. He sent me for all sorts of testing to rule out MS and lots of other things. I have had migraines every day since January. Since all the testing has came back negative, they first diagnosed it as TIA, and then since that came back negative they have diagnosed me as having complicated migraines (May 2010). The numbness comes and goes whenever it wants and the migraines get so severe sometimes all I can do is cry cause they hurt so much, they have me on migraine meds and not sure they are helping too much…Anyone else have any input on what to do?? The numbness is like when you fall asleep on your arm and its all tingly and it wont go away for hours or days…
Thanks
Brittany
alkoholik4eva@yahoo.com
I have had these symptoms for about 3 years. My left pupil blows, my right lid droops and I have a headache on the left side. My headaches aren’t always extreme. I have seen my GP. He referred me to a neurologist. He ran CT scans, blood work, and MRI’s with and without contrast. All were normal. I work for an ophthalmologist, so he checks me everytime I have and “episode”. He has ruled out Horners Syndrome and can’t find any reason for the symptoms. I had my worst episode yesterday. My left pupil was suddenly completely dilated, very little drooping on the right side. I did have a headache, but not severe. I could hardly speak and was sweating profusely. Our in-house RN took me to the hospital. After an immediate CT scan that was normal, blood work that was normal and 6 hours in the emergency room, they finally admitted me. They did another MRI this morning and found nothing. I saw another neurologist last night and today. She diagnosed me with complicated migranes. She has prescribed a blood pressure med, even though I am already on another. She didn’t seem too concerned. But I have never even heard of a complicated migrane! Does any of this sound familiar to anyone?