this is what My Neuro says I have,Basilar Migriane,
it explains all my cooky problems,
Basilar migraine is a rare disorder that most often occurs in children and rarely presents in patients older than 50 years.
·Attacks are marked by two or more aura symptoms originating from the brain stem or both occipital lobes, including visual changes, dysarthria,
· Speaking softly or barely able to whisper
· Slow rate of speech
· Rapid rate of speech with a “mumbling” quality
· Limited tongue, lip, and jaw movement
· Abnormal intonation (rhythm) when speaking
· Changes in vocal quality “nasal” speech or sounding “stuffy”
· Drooling or poor control of saliva
· Chewing and swallowing difficulty
vertigo, tinnitus, decreased hearing, double vision, ataxia Ataxia comes from the Greek a taxia, meaning literally “no order”. It is a blanket term referring to a loss of ability to control one’s muscles. Ataxia has a number of causes
bilateral paresthesias, Paresthesia or paraesthesia (in British English) is a sensation of tingling, pricking, or numbness of a person’s skin with no apparent long-term physical effect, more generally known as the feeling of pins and needles or of a limb being “asleep” (but not directly related to the phenomenon of sleep). Its manifestation may be transient or chronic.
bilateral paresis, and decreased level of consciousness.
Patients with basilar migraine may also have other types of migraine
. The aura usually lasts from 5 to 60 minutes but can last up to 3 days.
Visual symptoms–which usually take the form of blurred vision, shimmering colored lights accompanied by blank spots in the visual field, scintillating scotoma, and graying of vision–may start in one visual field and then spread to become bilateral. Diplopia occurs in up to 16% of cases. Vertigo may be present, either alone or accompanied by various combinations of tinnitus, dysarthria, gait ataxia, and paresthesias (usually bilateral, but sometimes affecting alternate sides in successive episodes). In 50% of cases, bilateral motor weakness occurs. Impairment of consciousness is common and may include obtundation, amnesia, syncope, and, rarely, prolonged coma. A severe throbbing headache, typically with a bilateral occipital location, is present in 96% of cases. Nausea and vomiting typically occur, with light and noise sensitivity in up to 50% of cases.
Benign paroxysmal vertigo / co morbid.
of childhood presents as episodes of vertigo without headache. Abdominal migraine also occurs in children and features recurring episodes of abdominal pain without headache that may be associated with nausea, vomiting, pallor, and flushing. Confusional migraine presents with a headache, which can be minimal, associated with a confusional state that can last from 10 minutes to 2 days.
Agitation and impaired memory may be present. The patient may exhibit inattention, distractibility, and difficulty maintaining coherent speech or action. So-called footballer’s migraine (originally described in soccer players) refers to the triggering of migraine by acute minor head trauma in children or adolescents.
Prodromal symptoms (premonitory phenomena), which may be present in about 10% of cases and precede the migraine attack by hours or up to 1 or 2 days, include changes in mental state such as depression, hyperactivity, euphoria, talkativeness, irritability, drowsiness, or restlessness.
Neurologic symptoms may include photophobia, difficulty concentrating, phonophobia, dysphasia, hyperemia, and yawning. Hyperemia describes the increase of blood flow to different tissues in the body. It can have medical implications, but is also a regulatory response, allowing change in blood supply to different tissues through vasodilation.
General symptoms may include stiff neck, food cravings, feeling cold, anorexia, sluggishness, diarrhea or constipation, thirst, and fluid retention.
There are triggers unique to women. Half of women with migraine report menses as a trigger, and 14% have migraines associated only with their menses.
During pregnancy, the frequency of migraines decreases (especially during the second and third trimesters) in 60%, remains the same in 20%, and increases in 20%. Migraines may occur for the first time when women start using oral contraceptives (OCs). Low-estrogen OCs usually has no effect on migraine or may even improve it, although frequency can increase. Of patients with new-onset migraine or increased frequency of migraine associated with OCs, 30% to 40% may improve when OCs are discontinued, although improvement may not occur for up to 1 year. Two thirds of women with prior migraine improve with physiologic menopause. Surgical menopause results in worsening of migraine in two thirds of cases.
The migraine aura has a total duration of usually less than 1 hour and frequently less than 30 minutes. An aura lasting more than 1 hour but less than 1 week is termed migraine with prolonged aura, or complicated migraine. The most common aura is a visual one, which is present in 99% of cases and has two types: positive visualphenomena, with hallucinations; and negative visual phenomena or scotomas, with either an incomplete or complete loss of vision in a portion or all of the visual field. Most visual auras have a hemianoptic distribution Hemianopsia is a blindness or reduction in vision in one half of the visual field. Hemianopsia can be caused by conditions such as stroke, tumors and trauma. The cause of a hemianopsia must always be carefully investigate by the patient’s physicians. Hemianopsia may vary from an absolute loss of all vision on one side to a relative loss where vision is reduced, but not completely missing…
Photopsias consist of small spots, dots, stars, unformed flashes or streaks of light, or simple geometric forms and patterns that typically flicker or sparkle. A scintillating scotoma, also called a fortification (because of its resemblance to a medieval fortified town as viewed from above) spectrum or teichopsia (seeing fortifications), is present in about 10% of cases. The scotoma, which is frequently semicircular or horseshoe shaped, usually begins in the center of the visual field and then slowly extends laterally. The scotomatous arc or band is a shimmering or glittering, bright, zigzag border. Most visual auras consist of flickering, colored or uncolored, unilateral or bilateral zigzag lines or patterns, semicircular or arcuate patterns, wavy lines, or irregular patterns. Rare visual auras include metamorphopsia (objects appear to change in size and shape), macropsia, micropsia, telescopic vision (objects appear larger than normal), teleopsia (objects appear to be far away), mosaic vision, Alice in Wonderland syndrome (distorted body image), and multiple images. Headaches, when unilateral, usually occur on the side contralateral to the visual symptoms but can occasionally be ipsilateral.
A sensory aura, which is present in about 30% of episodes of migraine with aura, consists of numbness, tingling, or a pins-and-needles sensation. The aura, which is usually unilateral, commonly affects the hand and then the face, or it may affect either one alone. Paresthesias of one side of the tongue is typical. Less often, the leg and trunk may be involved. A true motor aura is rare, but sensory ataxia or a heavy feeling is often misinterpreted as weakness.
Speech and language disturbances may occur in up to 20% of cases. Patients often report a speech disturbance when the spreading paresthesias reach the face or tongue. Slurred speech may be present. With involvement of the dominant hemisphere, paraphasic errors and other types of impaired language production and comprehension may occur. Rarely, other aura symptoms may be described, including dj vu and olfactory and gustatory hallucinations. Although visual symptoms frequently occur by themselves, combinations of aura symptoms can occur. Sensory, speech, and motor symptoms are usually associated with visual symptoms or with one or more other symptoms. When two or more aura symptoms are present, they almost always occur in succession rather than simultaneously.
Migraine aura can occur without headache often in patients who typically have migraine with or without aura. A visual aura is the most common in these cases. Another type of acephalgic migraine is episodic vertigo without a headache, auditory disturbances, or other neurologic symptoms, lasting minutes to days.17 In older persons, the aura–termed late-life migraine accompaniment–can be confused with a transient ischemic attack (stroke), Rarely, migraineurs may have persistent visual aura. This usually consists of simple, unformed hallucinations in the entire visual field of both eyes, including innumerable dots, television static, clouds, heat waves, flashing or flickering lights, lines of ants, a rainlike or snowlike pattern, squiggles, bubbles, and grainy vision. Occasionally, palinopsia (the persistence of visual images), micropsia, or formed hallucinations occur.