Suggest Treatment For Migraine With Dizziness And Brain Fog

Question : I have noticed lately that my vision at times is blurry when I am fixated on a object but other objects are moving especially in darker rooms that have lights overhead. For example if you were 5 feet away from me and we were taking if you raised your hand fast I would see it like in blurry like in frames. I know when objects move it's normal to see stuff in blur frames but lately for me this is way more pronounced, like I feel it should not be happening as dramatic. I have a migraine type headache from time to time not sure if related. what type of illness can point to the vision issue I am having at times?
Apparently since multiple mris in the past that I have had are clear I have a vestibular type of migraine going on. I get dizzy-off balance-brain fog for days at a time.

However I also get facial numbness on both sides of my face under my eyes and around my nose, and on cheeks. This numbness can easily last days at a time. All the doctors i have seen say it's unusual on the duration but common with migraine. I am not convinced. In your opinion does this sound like migraines? What else could I look into?

Here is my story. Currently 31 male, very athletic. In 2008 out of nowhere, I woke up to strictly LEFT side facial numbness. No other symptoms. It was like I had a shot of Novocain from the dentist on the left side of my face. I did have a pretty bad undiagnosed lengthy (couple months) flu-like illness with swollen lymph nodes - sick a couple months prior to this. I also had flipped a tractor a couple weeks before this. Not sure and never found out if those were related to the LEFT sided facial numbness, but could be clues. Anyways, this numbness came from nowhere, woke up to it and was very intense for over a year, 24 hours a day, non-stop. At first they thought I had trigeminal neuralgia, but the symptoms for that didn’t match exactly, so that was ruled out. Hi-def MRI focused on the Trigeminal nerve was clear, and the overall MRI was unremarkable. They basically told me they didn’t have an answer but was not trigeminal neuralgia. About a year after the intense left sided facial numbness started I then developed an actual headache (up until this time in my life I had never had a headache). The headache started off as mild, with allot of dizziness and off balance, brain fog etc. At this time the LEFT sided facial numbness had gone from like 10 to a 3. (improved), however the headaches got much worse. The headache tuned into what I would call a chronic daily headache. I basically had a headache all day every day. It would be described as DULL and constant, no pulsation. Def had neck pain at times with it. Kind of like a vise put my head. And yes light and sound def bugged me at times. I always felt good during sleep. A couple of times the headache got pretty intense, so I had further tests done, which included more MRIs, CT Angiogram, and MRAS. (2010). Besides a very small right vertebral artery, left robust, everything else looked good. Again still at this time, basically a headache all day every day, also had brain fog, just felt plain sick. At that time I kind of gave up as the doctors were no help and I had a million tests done with nothing. Around 2011 the headaches started to change. Instead of pain, I would just like feel “high, confused, brain fog”. Then eventually over the next several months they just kind of went away. From late 2011 to 2015 I really didn’t have any complaint of a headache. Now of course I still had an occasional symptom or minor headache, but nothing like before, and in my option life was great and the bad headaches were gone! I will note that during this time and even up until now, I still do have SLIGHT left sided facial numbness. However instead of a 10, it’s like a 2 and I have learned to live with it. But from late 2011 to 2015 things were really good, I had no restrictions from my head, could do whatever, have fun, race motocross, drink beer, whatever, it was heaven compared to the hell I was in years before. Yes I had an occasional headache or lightheadness, but nothing like before.

So current situation. In the spring of 2015, I had a couple episodes of where I kind of felt lightheaded for a couple days at a time, no headache, no big deal just wanted to mention it. Then one day in July 2015, both sides of my face started to tingle-numbness. (my nose, and mainly under my cheeks), this lasted for about 3 days. After this ended, the vestibular symptoms started. I would get dizzy, off balance for over a week straight. Not a true vertigo but it was pretty BAD. I felt like I was being pushed from the side, or just got off a roller coaster. Waxed and waned all day. At night when sleeping I always felt fine. This cycle just kept going. Bi-lateral facial tingling for around 3 days, followed by near a week of the vestibular symptoms with no relief. I had NO headache at all during this time, not one……. In August, I had a high def. 3T MRI with no contrast to look at the brain and trigeminal nerve. It was clear. I then went to a balance-vestibular center. They did the ear tests, rotation chair etc. All test were normal expect the rotary chair, which was abnormal. The doc said in light of a clear MRI, he points this to a brain chemical problem, AKA vestibular migraine. He said my inner ears were fine, and that it was something with the vestibular system. Since Aug, I eliminated caffeine from my diet and beer to see if that would help. Didn’t really make a difference. I keep a log, and had some better days in the last couple months, and have seen a slight improvement from the severity of the dizziness. But it’s still there. My main complaints are the facial tingling and the dizziness, vestibular symptoms. Now like I said at first I didn’t have ANY headaches with this, for the first 2 months. But in the last month, at times I have. The headache feels like a hangover headache when it happens, is not terrible and I can’t pinpoint in on a timeline with the other symptoms. Usually only lasts an evening then is gone. Also as I mentioned my vision at times seems a little off with movement/blurry. Lately it seems like I will have a good couple days where I feel pretty good, and then will have a flare up where I get the bi-lateral facial numbness, dizziness, vestibular symptoms, occasional headache. I can’t find any triggers. I will tell you that being in a car, grocery store, anything with visual stimulation seems to make it worse. The facial numbness is really annoying and same as the vestibular symptoms. As far as in office testing, the simple tests the doctors have done have been normal. I have no weakness in any limb at all and all my reflexes are always normal, can walk heal to toe, etc.

My issue with the vestibular migraine diagnoses is the facial numbness does not fit from what I have read, otherwise it’s like right on. With the basilar migraine you mentioned, the headache doesn’t fit. The subclavian steal seems pretty rare, and I don’t see any difference when using my arm with anything. What test can I have to rule this out? As far is XXXXXXX TIAs you mentioned, what test would rule that out and do they seem likely? Are there any other things you can think of neurological or anything else infectious disease etc? I mentioned MS and they said no because of clear imaging. I just feel like something is missing. I did have a “Lyme” literate doc tell me I had Lyme disease back when this all started, from a positive IGNEX Lyme test. However my primary care doctors said no they don’t believe in that companies tests, and that my standard CDC tests were all negative, so that steered me away from that diagnoses. I just don’t know where to go with this. My doctors want me to try Verapamil or Topamax to as a preventative medicine, which I am going to try, But my fear is something is being missed. The past history of LEFT sided facial numbness and now this bilateral facial tingling don’t make sense to me. Then again I guess people with migraines can get numbness, tingling. I do have a grandfather with a history of migraines, but besides that no one else, I have 5 brothers and sisters. Sorry for the long story, but I am looking for ANY ideas on what I can look into. Any options, suggestions, alternative diagnoses to look into would be greatly appreciated. Thank you very much. Could something have developed in brain maybe after this MRI was taken, that was missed?