a - ophthalmoplegic migraines (dilated pupil) &

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Here are two answers to posts on a neurological forum that you might find interesting/helpful. The first response is from a neurologist regarding a question from a headache sufferer (sounds like a decent doctor). The second from a person who's husband had unrelenting head pressure until dx'd with cervical facet headache. penny --- Dear Lori: I am sorry to hear of your problem. First let me describe the usual ophthalmoplegic migraine, usual jpresents with acute attacks of third nerve palsy (which for the person with the migraine would be blurry or double vision), dilated pupil (go to the mirror and see if one pupil is larger than the other). The pain is usually unilaterl, and is migrainous in quality. The duration of symptoms is usually hours to days. Now with that said, I have seen variation in this. The pain in some patients is present but not migrainous. Some of my patients have a duration of only

40-90 minutes. Given that, with each of these patients I did a full work-up to eliminate those entities that can mimic this disease. I would do a MRI to rule out aneurysm, do some blood work to rule out infection, and EEG to rule possible epilepsy. The things that are atypical need to be worked up, in my opinion. Given what I have said, your symptoms have alot of qualities that sound like ocular migraine. The only symptoms that really don't fit are the lack of pain, and the duration. It doesn't sound like it is related to your heart. The symptoms are too numerous and completely resolve, with no fixed deficit. This might occur, although very rare, if you septal defect allowed right to left blood flow during a valsva condition. On usually get bradycardia with maybe a rebound increase in heart rate. This might send emboli into the opthal. artery and cause stroke. So, enough said, I think your physician is likely correct, but, if he/she hasn't tested for the possible other

diseases that can cause these events, I might suggest just getting a second opinion. Let us know how things turn out. Sincerely, CCF Neuro[P] MD, RPS http://www.medhelp.org/forums/neuro/archive/12004.html I feel compelled to tell you that for the last two years, my husband has experienced 24/7 head pressure....not headaches, but chronic PRESSURE. We've been through every test imagineable, and every doctor we thought could help him. No diagnosis, no help, and no relief for him. This past February we were very fortunate (yes, fortunate) to have his neurologist throw his hands up in the air and say, "I don't know what's wrong, so I can't fix it. But, I will not abandon you."He then referred us to the Michigan Head Pain and Neurological Institute in Ann Arbor, Michigan (www.mhni.com). These folks have saved

my husband's life. After two years of searching desperately for an answer, they had a diagnosis and a solution to his problems in seven days. His symptoms included: lightheadedness, ringing in ears, equillibrium problems, memory loss, coordination problems, and a strange inability to walk through stores or crowded places without being adversely affected by people passing him in the aisles. He described it as a "spacey" feeling, constantly, like his head was on drugs or just a lazy brain. I'll tell you that we were at our wit's end when we finally found MHNI.Please look at their website and every place you see the word "headache", replace it with the word "pressure" and find out if you might be able to benefit from this wonderful facility.We can't say enough about Dr. Saper and his staff. After seven days my husband was feeling better and he is now on his last leg of treatment. Seems that all his symptoms up his neck and into the back of his head creating

the pressure etc., were referred by his cervical spine. His treatment required a two-week stay in the hospital while Dr. Saper's staff took complete control of my husband and his medications. I can tell you that we had film of every MRI, CT Scan, X-ray that was ever taken and these had all been shown to every doctor we had visited before MHNI. No one found anything out of the ordinary, or could give us a cause for my husband's chronic symptoms, until MHNI. Like you, my husband did all the steroids, nasal sprays, and even had sinus surgery, thinking all his symptoms were related to a deviated septum, or allergies. Nothing helped.After two years of searching, we now finally have a cause and a treatment. I hope that maybe these folks will be able to give you relief.Good luck. http://www.medhelp.org/forums/neuro/messages/34794.html