My daughter is 20 and very fit until a week ago when she passed out during a very severe headache attack, nauseous, very unsteady on her feet and slurring her speech as though she was drunk.
I took her to a British NHS hospital where she was admitted. A neurologist saw her, said it was migraine and discharged her 2 days later. The following day she was worse so we returned to A and E and she was re-admitted. The neurologist wanted to discharge her again but following our very strong complaints a different neorologist decided to keep her for an MRI.
Vertical and horizontal scans have revealed 5 ’spots’ in both elevations that must therefore be 3D lumps the same colour of the matter on the preiphery of the image. The neurologist does not know what they are but has offered that they might have been excreted by the blood vessels during her severe migraine attack. He took further blood tests in order to eliminate Hughes Syndrome. We do not know the results of the tests because she was immediately discharged again and is now home for the weekend.
As parents of a 20 year old, we have restricted access to the doctor but we intend talking to him on Monday with our daughter. During the course of today, she has deteriorated and is now slurring her speech quite badly, walking unsteadily, has a bad headache and is therefore resting in bed. The neurologist prescribed Anadin to thin the blood in case it is Hughes Syndrome, Ametryptoline and Panadol which appears to be ineffective for the headache.
Does anyone have any idea what this is? There are so many questions we have for Monday but we are very worried about our daughter’s health and the lack of information.

Doctor Joshua’s Answer

As she has been examined by neurologists, I’m not in a position to second-guess her own doctors. My knowledge of her history, neurological examination and so on is practically zero, so I cannot give any diagnosis or treatment suggestions.

Based entirely on the short description of events that you provided, I would say that, generally speaking, if she has ongoing neurological symptoms, including speech and motor deficits, she should be admitted immediately and thorough examinations should be done promptly in order to get a diagnosis and start a treatment. I’m glad the MRI was taken- I cannot comment on the MRI based on your vague description, but would like to see the radiology report.

Migraines do not cause persisting neurological symptoms except in some very rare, severe cases. Before a diagnosis of migraine can be done, especially if the symptoms are not typical of migraine, other more serious causes need to be ruled out. In young females, headaches with neurological symptoms may be caused by a number of serious conditions, including but not limited to sinus thrombosis, subarachnoid hemorrhage, vasculitis, hydrocephalus, idiopathic intracranial hypertension (pseudotumor cerebri), spontaneous intracranial hypotension, meningitis (infection), stroke, and so on.