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Severe Headache Attack, High BP, Temporary Paralysis. On Dicorate ER. Help?

hi I have a one sided severe headache attack which occurs at irregular occasions/intervals. This pain also results in temporary hike in BP (last time it went upto 230) and temporary paralysis (something of that sort: My left arm and leg does not respond at the time of attack). I was advised to take Dicorate ER 750 at the onset of pain. Should I always keep this medicine with me or is there an end to these attacks?
Wed, 2 Jan 2013
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Psychiatrist 's  Response
Hello and welcome to Healthcare Magic. Thanks for your query.

From the brief description of your symptoms, a likely cause could be a migrainous headache (which rarely present with transient neurological symptoms like paralysis). Another possibility which has to be considered in this scenarion is a transient ischemic attack (TIA). This is a condition where a person can transietly experience neurological symptoms such as headache, paralysis, etc., which resolve after a brief period. This condition is caused due to a temporary decrease in the blood flow to the brain.

A rise in BP can be associated with a migraine as well as a TIA. However a BP of 230 is very high and can be potentially dangerous. I hope you have had a detailed neurological evaluation to rule out any major neurological problems or complications. Dicorate ER (Divalproate sodium) is an anti-epileptic medication which can sometimes be effective in the treatment and prvention of migrainous headache. It is difficult to say how long you will have to continue the medication, since this varies widely from person to person, depending upon the nature and severity of the problem.

Wish you all the best.

Regards,
Dr. Jonas Sundarakumar
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Neurologist, Surgical Dr. Visvanathan K's  Response
Hi,

From your description you seem to have a condition called hemiplegic migraine. Your doctor has prescribed you on a medicine which will help prevent the attacks and therefore will have to be ideally taken continually rather than at the onset of an attack. Therefore it is likely you will have to continue this medicine indefinitely. What is more important is that you are under close follow-up and prescribed medicine to prevent occurence of strokes in the future. I am sure you have been evaluated with appropriate imaging tests as well?
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  User's Response
Dr. Harmandip Singh's  Response
hello koushel , you should regularly monitor your blood pressure use blood pressure daily without missing a single day, i advice you start with losartan plus amlodipine combination.
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Severe Headache Attack, High BP, Temporary Paralysis. On Dicorate ER. Help?

Hello and welcome to Healthcare Magic. Thanks for your query. From the brief description of your symptoms, a likely cause could be a migrainous headache (which rarely present with transient neurological symptoms like paralysis). Another possibility which has to be considered in this scenarion is a transient ischemic attack (TIA). This is a condition where a person can transietly experience neurological symptoms such as headache, paralysis, etc., which resolve after a brief period. This condition is caused due to a temporary decrease in the blood flow to the brain. A rise in BP can be associated with a migraine as well as a TIA. However a BP of 230 is very high and can be potentially dangerous. I hope you have had a detailed neurological evaluation to rule out any major neurological problems or complications. Dicorate ER (Divalproate sodium) is an anti-epileptic medication which can sometimes be effective in the treatment and prvention of migrainous headache. It is difficult to say how long you will have to continue the medication, since this varies widely from person to person, depending upon the nature and severity of the problem. Wish you all the best. Regards, Dr. Jonas Sundarakumar