[Sam]

About a week before a major breakthrough migraine, I become extremely depressed, withdrawn and have suicidal ideations. For a long time I thought it was just me, but recently came upon an article about a pre-aura. Many people get auras, flashing lights, spots before thier eyes, but the pre-auras come before that. The depression lasts about a week and is followed by a sudden, severe breakthrough that even my rescue injections can't stop. I can't talk, often lose all sense of where I am, what day it is and am told I vocalize at times. The breakthrough can last up to ten days. Occassionally a nosebleed on the effected side occurs as well.

Does anyone else expeience this phenomenon, and if so, how do you deal with it? My rescue injections are meperidine with phenergan, the only thing that even touches regular breakthroughs. My Pain Dr. has tried everything he knows and we usually try new things as well, but you never know. If anyone has any information that might be helpful, I would really appreciate the input.

Sam

[Dr. Smith]

That's a new one on me. The only preaura I've heard of relates to epilepsy (and I asume that would have been checked out/eliminated). Your description does make me wonder though, about the cause/effect (and I'm just thinking aloud here); is the preaura caused by the episode coming on, or is the episode the result of the preaura? It almost sounds like a chemical imbalance (like depression) causing the aura, which in turn leads to the migraine. But I gotta figure you've been through all the migraine prophylactics and antidepressants....

Is your doctor a migraine specialist? There are directories -- I think I sent you one. When mine were at their worst, I would have made the trip out of state to see one/more (turned out there was one in my area) but I don't recall if you've been down that road either...

Looking for migraine doctors?

Another thought just occurred to me... Have you had these preauras from the get-go, or are they something that's developed/evolved after a while?

Doc

[Sam]

I really don't know how long the pre-auras have been there. It was not until last year that I began noticing a pattern. I knew it was happening but had no explaination of just a few months ago when I stumbled on the article. (wish I could remember where I read it. All i know was that is was a medical article, written by an M.D.)

I do have depression, and have been since i was about ten. it does not seem to be the cause, or at least not on its own. Many of my Dr.'s patients suffer from migraines. He consulted several headache clinics when he felt he had hit a wall, but they didn't do anything that we had not already tried. My Dr. is not a GP, but rather a boarded anesthesiaologist with a chronic pain specialty. He runs a pain clinic in town. They require a contract prior to treatment. Patients at the clinic are not allowed to use any pain medication prescribed by another Dr. unless that Dr. checks with the clinic first. They also run frequent urine screens to make sure patients are taking what they are supposed to. No more and no less.

Rather a long answer for your question. There are multiple triggers for my migraines, and we have eliminated as many as possible, but rather than growing out of them, I seem to be growing into them.

Sam

[pabb]

It has been posited that migraines are part of the seizure spectrum. Have you been thoroughly checked out for sz? Have tried antisz meds?
do you keep a food journal? If you do, you may need to go back 3 days to get a common food. Good luck.