Hi Sam!

Thanks so much for sharing more information with us. I also hope we can help you, somehow, even if it's helping you to recall some information and helping you to put the puzzle pieces together in order to present them to your parents and your doctor(s). You strike me as a very insightful young man, with wisdom beyond your chronological age. You are highly motivated to feel better. I honestly believe you have an excellent chance of coming to an understanding of, and also an excellent chance of overcoming, your current challenges.

I understand you have had similar, though less frequent and maybe less intense, episodes prior to the concussion. Concussions have their own ways of expressing our brain's response to the trauma, and they can often further aggravate pre-existing tendencies.

I had asked about family history of migraine and the other questions because I am somewhat familiar with migraines and "migraine variants." I am familiar with these because they run in my family, on both sides, maternal and paternal.

Please note: "Acephalalgic migraines" are migraines without headaches.

What are migraine variants?

"Migraine variant is characterized by paroxysmal episodes of prolonged visual auras; atypical sensory, motor, or visual aura; confusion; dysarthria; focal neurologic deficits; gastrointestinal (GI) manifestations; or other constitutional symptoms, with or without a headache.

A detailed headache history is necessary to establish the diagnosis of migraine variants. As many as 20% of patients with migraine variant may experience prodromal symptoms without subsequent headaches. Such paroxysmal symptoms, with the recurrent attacks of transient neurologic symptoms, with or without headache, with a positive family history of migraine, and with a normal neurologic examination interictally, are confirmatory.

Interictally, the neurologic examination is nonfocal. Ictally, hemiparesis, ophthalmoplegia, or altered consciousness may be observed."

http://emedicine.medscape.com/articl...31-overview#a1

(Migraine Variants Author: Rima M Dafer, MD, MPH, FAHA; Chief Editor: Helmi L Lutsep, MD . June 23, 2015.)

Sam, this article outlines a lot of information about migraine variants. Please note: the link brings you to the full article and also allows you to print the article.

Migraine variants can present in the most confusing ways.
I have both migraine with severe headache and acephalalgic migraine (no headache) with lots of other odd symptoms, which can include periods of "altered consciousness."

I often smell something burning, when nothing is burning. I search high and low for the fire and there is no fire and no visible smoke. People experiencing these migraine variants may smell lots of odors which others do not smell. It doesn't have to be the smell of something burning, per se, however, the burning odor example is a common example.

This article also outlines "differential diagnoses," which are conditions with similar symptoms which might also be considered and ruled-out through testing. I was thinking of some of these "differentials" when asking you questions. (I know of people with migraine variants and people with a subtle form of temporal lobe epilepsy experiencing similar symptoms, for example.)

I don't want to overwhelm you with too much information in one post.

I can tell you, from my own experience and from knowing others dealing with migraine and/or migraine variant (including migraine without headache), the experiences you describe sound familiar. This information I am sharing is not diagnostic.

I am hoping you can use this information to obtain very thorough neurological testing, including EEGs and more, from a highly qualified neurologist.

I can also tell you I have had a concussion, just over 2 years ago now, and many of these migraine/migraine variant symptoms, which had previously quieted down for a few years, were back, were severe, and were and making daily life very challenging. I am continuing to recover/improve, as I write this to you today.

I agree with our friend "bizi," in wondering if you have seen a neurologist and if you have had extensive testing beyond an evaluation for concussion. You have mentioned you had these episodes prior to concussion. I had wondered about this and am glad you have shared more about the timeline of symptoms.

I suspect the concussion has possibly aggravated a condition/predisposition you may have had prior to the concussion.

I hope this information, the Medscape article and my sharing from my own experience, may prove helpful to you, soon. Migraine and various forms of the more subtle types of epilepsies can be complicated and can be very tricky to accurately test/diagnose.

I am sure other friends here will come along with additional information and potential insights. We are committed to supporting you as best we can. I truly appreciate your patience and your honesty as you share. It's easy to support you, as you are highly motivated to feel better.

I hope you are enjoying your weekend, Sam!



With Love and Supportive Prayer,
DejaVu


P.S. Oliver Sacks has written an excellent book on migraine, entitled Migraine. He did an amazing job of writing about migraine variants in his book. This is an older book now; however, it has helped me and has helped many of my physicians to better understand "migraine variants" when there was less published in medical journals on this topic. (His book was initially published in 1970, revised in 1992.)