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What Causes Migraine, Dizziness, Nausea, Blurred Vision And Tremors?
Question: Hello, ok so I asked a question 4 days ago about a migraine I was having along with dizzy spells and tremors. On that day my migraine had been going on for 8 days, well today is day 12 of the migraine. When I contacted you all I was told to maybe consider a Basilar migraine. And that I should see my doctor ASAP and probably go to the hospital for a day or 2. Well I went the next morning to my Physician and she completely agreed. She wrote me up paperwork and sent me to the ER and wanted me to be admitted. The hospital doctor refused to admit me. He gave me 2 liters of fluids through an IV over 1 hour and a "migraine cocktail" which made my migraine worse and they ended up having to give me pain Medes and then they did a normal CBC and a CT after I pushed for it. After that the doctor discharged me saying I had a severe migraine and vertigo. I am at a loss for words and I do not know what to do. The ER doctor knew that 2 years ago I had an MRI that a lesion was found on my brain and still refused to do an MRI because he would have had to admit me. I left the hospital very dehydrated, I still have the migraine, dizzy spells, afraid to drive my vehicle, blurred vision, slight confusion and sometimes hard times speaking, vomiting and nausea
Brief Answer:
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Detailed Answer:
I read your question carefully and I understand your concern.
Judging from the medications tried you do seem to have exhausted the list of analgesics which can be used at home. There are the triptans, the most used for migraine, but the trouble is that they aren't advised if a basilar migraine is suspected. I am not so sure it is a question of basilar migraine as those symptoms of dizziness could also be simply due to dehydration, however it remains a possibility.
I do agree with my colleague that 8 and even more so 12 days are too many for a simple migraine. They do require medical attention in a hospital setting, starting with hydration, medication to interrupt the status migrainosus (like iv valproic acid, steroids) and a neurological consult to consider other possibilities (if you used pain killers too often in the last months medication overuse headache is another possibility). Where the doctor at the ER might be right is about the necessity of an MRI, that is not necessary by all means if CT is ok, brain lesions causing such headache should be seen on CT, but that doesn't mean you shouldn't be admitted. I am afraid doctors on this site can't help with that though, so I would suggest you return to the ER again. Perhaps the persistence of the symptoms will convince the doctor this time around, if it is the same doctor that is, might be another one more willing to have you admitted.
I remain at your disposal for other questions.
Read below
Detailed Answer:
I read your question carefully and I understand your concern.
Judging from the medications tried you do seem to have exhausted the list of analgesics which can be used at home. There are the triptans, the most used for migraine, but the trouble is that they aren't advised if a basilar migraine is suspected. I am not so sure it is a question of basilar migraine as those symptoms of dizziness could also be simply due to dehydration, however it remains a possibility.
I do agree with my colleague that 8 and even more so 12 days are too many for a simple migraine. They do require medical attention in a hospital setting, starting with hydration, medication to interrupt the status migrainosus (like iv valproic acid, steroids) and a neurological consult to consider other possibilities (if you used pain killers too often in the last months medication overuse headache is another possibility). Where the doctor at the ER might be right is about the necessity of an MRI, that is not necessary by all means if CT is ok, brain lesions causing such headache should be seen on CT, but that doesn't mean you shouldn't be admitted. I am afraid doctors on this site can't help with that though, so I would suggest you return to the ER again. Perhaps the persistence of the symptoms will convince the doctor this time around, if it is the same doctor that is, might be another one more willing to have you admitted.
I remain at your disposal for other questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
So today I had 5 dizzy spells lasting around 30min. I spoke with a doc late last night after speaking with you and he told me to take 2 baclofen and 2 lorazepam and that my migraine would be gone when I woke up in the morning. When I woke up my migraine was less but about an hour and a half later it came back fully and I started getting the blurred vision, nausea, light and sound sensitive and dizzy spells. I am on ondasterone for nausea and meclizine for dizziness. Now the dizzy spells are affecting my life, I am having trouble driving my car. I had to pull over my vehicle in the middle of a dizzy spell and sit for 20 min. I was afraid to drive. What do I do? What is wrong with me? I am afraid...
Brief Answer:
Read below.
Detailed Answer:
Hello again!
You do not have to be afraid. The CT is normal so there should be no life threatening issue at play.
You shouldn't be taking medications as lightly as that. As I said in my previous answer one of the possibilities for persisting headache in someone with a history of migraine is medication overuse headache. You mention among your medication hydrocodone and fioricet, both medication prone to cause medication overuse headache if used frequently. So shouldn't add more drugs to the mix that lightly, that doc who recommended them should've thought twice before recommending such prescription only medication like baclofen and lorazepam.
As I said before adding more drugs you should present again at the hospital and ask to be seen by a neurologist. 14 days of headache are not normal. Even if it is no life threatening issue such as medication overuse headache or status migrainosus still they are diagnostic possibilities which necessitate admission and management in a hospital setting.
Read below.
Detailed Answer:
Hello again!
You do not have to be afraid. The CT is normal so there should be no life threatening issue at play.
You shouldn't be taking medications as lightly as that. As I said in my previous answer one of the possibilities for persisting headache in someone with a history of migraine is medication overuse headache. You mention among your medication hydrocodone and fioricet, both medication prone to cause medication overuse headache if used frequently. So shouldn't add more drugs to the mix that lightly, that doc who recommended them should've thought twice before recommending such prescription only medication like baclofen and lorazepam.
As I said before adding more drugs you should present again at the hospital and ask to be seen by a neurologist. 14 days of headache are not normal. Even if it is no life threatening issue such as medication overuse headache or status migrainosus still they are diagnostic possibilities which necessitate admission and management in a hospital setting.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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