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My wife has botox once a month for chronic migraines.

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Neurologist, Surgical
Practicing since : 2004
Answered : 2839 Questions
Question
My wife has botox once a month for chronic migraines. The migraines are accompanied by nausea, dizziness, blacking out, shaking, and passing out. The doctor tried Topomax; not very effective.
I feel as though this Neurologist is missing something, because migraines don't make people pass out suddenly, or start acting as if they were having a convulsion.

Some of the stuff my wife does is strange; she will sometimes lose her sight, then her hearing, then she passes out and shakes profusely. She does weird lip movements, and says weird things, too. The doctor's scanned her, found no signs of Epilepsy!

My wife did have a lumbar puncture; unsuccessfully:they did mention postural hypertension or vertigo, can't remember exactly. Do you think they are missing something?
Sun, 11 Feb 2018 in Headache and Migraines
 
 
Answered by Dr. Erion Spaho 1 hour later
Brief Answer:
Other examinations are necessary for a correct diagnosis.

Detailed Answer:
Hello and thanks for using HCM.

I have read your question and understand your concerns.

Migraine headaches may manifest with several symptoms, it is true that passing out is not a common feature, but it cannot be excluded entirely as a possibility.

However, first is necessary to exclude correctly the seizures and an EEG besides imaging studies is necessary for this purpose.

Postural hypotension or excessive lowering of the blood pressure after standing up from lying or sitting is another condition to consider.

Tilt table test is necessary to evaluate correctly this possibility.

Discuss with your wife’s Doctor about these examinations to be done in order to achieve a correct diagnosis.

Hope you found the answer helpful.

Let me know if I can assist you further.

Take care.
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