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How Do You Distinguish A TIA From A Migraine?
Question: How do you distinguish a TAI from a Migraine? I have symtptoms of both and am very worried which it is????
Brief Answer:
Neurologist consultation and investigations requir
Detailed Answer:
Hi XXXXXX ! Good morning. I am Dr Shareef answering your query.
Although it might sometimes be difficult to differentiate between the two, the following points might help us to predict as to what might turn out to be a TIA :
1) If you have got a family history of migraine, then it is more likely that you might be having attacks of migraine.
2) Usually migraine attacks are preceded by a phase of aura (where the person experiences some predisposing symptoms and knows that the migraine attack is imminent).
3) The symptoms of migraine develop slowly over a period of time, but in case of TIA the symptoms might develop suddenly without any warning.
4) There might be some predisposing factor for a TIA, like high blood pressure, high cholesterol levels, cardiac problems like the one you have (a-fib), or some other pathology like an arterial stenosis (narrowing), etc. However, because you yourself have got some of the predisposing factors which might be well under control and treatment, you won't be necessarily having a TIA, but might be having symptoms of a migraine. The differentiating point could be the suddenness of the symptoms which might point towards a TIA. At the same time, you should take proper preventive measures like proper medications to see that the attack of migraine (if it is) does not convert it to an attack of TIA, which is a possibility.
For this prevention, you might have to undergo regular check up by your cardiologist and physician to have proper control of your blood pressure, asthma, and the atrial fibrillation along with a prescription of blood thinning agents.
5) Some investigations which might already have been done in your case are a blood sugar estimation, serum lipid profile, kidney funtion tests, liver function tests, serum uric acid, carotid artery Doppler, an EEG, an MRI of the brain, and an echo-cardiograph. All these investigations and a physical examination by a neurologist collectively could put some light on the aetiology of your symptoms for further management. Till then you would be required to continue your medications as advised by your treating doctors along with a consideration of starting the blood thinning agent if not started till now.
I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.
Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef.
Neurologist consultation and investigations requir
Detailed Answer:
Hi XXXXXX ! Good morning. I am Dr Shareef answering your query.
Although it might sometimes be difficult to differentiate between the two, the following points might help us to predict as to what might turn out to be a TIA :
1) If you have got a family history of migraine, then it is more likely that you might be having attacks of migraine.
2) Usually migraine attacks are preceded by a phase of aura (where the person experiences some predisposing symptoms and knows that the migraine attack is imminent).
3) The symptoms of migraine develop slowly over a period of time, but in case of TIA the symptoms might develop suddenly without any warning.
4) There might be some predisposing factor for a TIA, like high blood pressure, high cholesterol levels, cardiac problems like the one you have (a-fib), or some other pathology like an arterial stenosis (narrowing), etc. However, because you yourself have got some of the predisposing factors which might be well under control and treatment, you won't be necessarily having a TIA, but might be having symptoms of a migraine. The differentiating point could be the suddenness of the symptoms which might point towards a TIA. At the same time, you should take proper preventive measures like proper medications to see that the attack of migraine (if it is) does not convert it to an attack of TIA, which is a possibility.
For this prevention, you might have to undergo regular check up by your cardiologist and physician to have proper control of your blood pressure, asthma, and the atrial fibrillation along with a prescription of blood thinning agents.
5) Some investigations which might already have been done in your case are a blood sugar estimation, serum lipid profile, kidney funtion tests, liver function tests, serum uric acid, carotid artery Doppler, an EEG, an MRI of the brain, and an echo-cardiograph. All these investigations and a physical examination by a neurologist collectively could put some light on the aetiology of your symptoms for further management. Till then you would be required to continue your medications as advised by your treating doctors along with a consideration of starting the blood thinning agent if not started till now.
I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.
Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Here's more info:
I have symtoms that occur upon awakening most of the time. They will include a headache, dizziness, loud ringing of the ears, numbness of an arm or leg and lack of balance. Sometimes I have been disoriented and one time I was unable to speak for about 30 seconds. I am sometimes also in a state of panic which is understandable. It seems like I am ok when I first awaken but as I sit up and my head clears, it starts......
I do have other episodes where they just come on while I am awake but they are usually coming along with a headache, visual things and lack of balance. And through all this illness has been BLOCKED sinuses, loud intermittent ringing of the ears and a very stiff neck. Nose is constantly full of thick mucous that I have to snort back because it won't come out ant other way despite Afrin, Flonaise, Saline spray and Patanaise. Nothing works...... Only antibiotics until I stop taking them. Then it returns....
I have sleep apnea and high c02 levels which I compensate for. I also have a very bad neck. Many disks c-3 to c-7 herniated w/ stenosis.
I also desaturate my oxygen at night. I am on 2 liters nasal canula and sometimes I wake up and the pulse ox says 71% and takes a while to climb back up to 98% which is my baseline.
THis is very confusing and terrifying. The doctors here are baffled and te local ER is very rude and thinks I enjoy going there. THey are planig to have me investigated for Medicare fraud I hear becuase I keep having to go there with stroke like symptoms. THey tell me they're not worried about it. Well of course not. They are not me and they'd probably throw a party if something happened to me. That's how bad and hostile that environment has become. THey are horrible. Have you ever heard of such behaviour from a medical "professional"?So i turn to you for help. Thank you....
I have symtoms that occur upon awakening most of the time. They will include a headache, dizziness, loud ringing of the ears, numbness of an arm or leg and lack of balance. Sometimes I have been disoriented and one time I was unable to speak for about 30 seconds. I am sometimes also in a state of panic which is understandable. It seems like I am ok when I first awaken but as I sit up and my head clears, it starts......
I do have other episodes where they just come on while I am awake but they are usually coming along with a headache, visual things and lack of balance. And through all this illness has been BLOCKED sinuses, loud intermittent ringing of the ears and a very stiff neck. Nose is constantly full of thick mucous that I have to snort back because it won't come out ant other way despite Afrin, Flonaise, Saline spray and Patanaise. Nothing works...... Only antibiotics until I stop taking them. Then it returns....
I have sleep apnea and high c02 levels which I compensate for. I also have a very bad neck. Many disks c-3 to c-7 herniated w/ stenosis.
I also desaturate my oxygen at night. I am on 2 liters nasal canula and sometimes I wake up and the pulse ox says 71% and takes a while to climb back up to 98% which is my baseline.
THis is very confusing and terrifying. The doctors here are baffled and te local ER is very rude and thinks I enjoy going there. THey are planig to have me investigated for Medicare fraud I hear becuase I keep having to go there with stroke like symptoms. THey tell me they're not worried about it. Well of course not. They are not me and they'd probably throw a party if something happened to me. That's how bad and hostile that environment has become. THey are horrible. Have you ever heard of such behaviour from a medical "professional"?So i turn to you for help. Thank you....
Brief Answer:
Please leave aside anxiety and do not panic.
Detailed Answer:
Hi XXXXXX! Good evening. My regrets for the delay due to my hospital work over here.
I am sorry to learn about your experience in the ER, but believe me, no doctor would like his patient not to recover from his illness if his medical practice is ethical. At times may be due to heavy work load, a medical professional might have become rude to you which should not have happened any ways and this is very much regretful. I am hopeful that things would improve in the ER where you go to get yourself assessed, and please leave aside your anxiety due to this.
The symptoms you have described are at a particular time like mostly on awakening, are slowly developing and you are aware of it (=Aura) that it is going to happen. All these I feel go towards attacks of migraine than that of TIA as described by me earlier.
Also giddiness and staggering could occur due to your cervical problems which you described now.So you should not become anxious or panic on these.
However, you should at intervals get yourself assessed by your neurologist in case of any doubt.
The nasal congestion and sleep apnoea is another story. Everything has been tried for your nasal congestion excepting for regular simple steam inhalation. I would suggest this for you about two to three times a day on consultation with your treating doctor. This would help in reducing the edema of nasal mucosa and indirectly would help you in bringing down the number of attacks which might be getting precipitated by the ringing in your ears due to the nasal problem.You have to anyways continue your treatment for the sleep apnoea as advised by the pulmonologist over there.
In any case, I would definitely counsel you not to get anxious and panic on such a situation and face it boldly. Please forgive any such behaviour of the medical team which you might have come across.
You are free to ask any other doubts in your mind. I am available here. Thanks and good luck.
Please leave aside anxiety and do not panic.
Detailed Answer:
Hi XXXXXX! Good evening. My regrets for the delay due to my hospital work over here.
I am sorry to learn about your experience in the ER, but believe me, no doctor would like his patient not to recover from his illness if his medical practice is ethical. At times may be due to heavy work load, a medical professional might have become rude to you which should not have happened any ways and this is very much regretful. I am hopeful that things would improve in the ER where you go to get yourself assessed, and please leave aside your anxiety due to this.
The symptoms you have described are at a particular time like mostly on awakening, are slowly developing and you are aware of it (=Aura) that it is going to happen. All these I feel go towards attacks of migraine than that of TIA as described by me earlier.
Also giddiness and staggering could occur due to your cervical problems which you described now.So you should not become anxious or panic on these.
However, you should at intervals get yourself assessed by your neurologist in case of any doubt.
The nasal congestion and sleep apnoea is another story. Everything has been tried for your nasal congestion excepting for regular simple steam inhalation. I would suggest this for you about two to three times a day on consultation with your treating doctor. This would help in reducing the edema of nasal mucosa and indirectly would help you in bringing down the number of attacks which might be getting precipitated by the ringing in your ears due to the nasal problem.You have to anyways continue your treatment for the sleep apnoea as advised by the pulmonologist over there.
In any case, I would definitely counsel you not to get anxious and panic on such a situation and face it boldly. Please forgive any such behaviour of the medical team which you might have come across.
You are free to ask any other doubts in your mind. I am available here. Thanks and good luck.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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