What could be the diagnosis for my wife's sudden vertigo and aphasia, other than migraine?

Question

Hello doctor,

My wife is 32-years-old with no medical illness. She suddenly experienced vertigo six days before, followed by aphasia and right-sided weakness. She was immediately taken to the emergency department for a stroke workup and stroke code. They did a head and neck CT and a brain MRI. The results were negative. Their final diagnosis was migraine with aura. But she is still having difficulty speaking for more than 72 hours.

Is there a differential diagnosis for this? Are we missing something here?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I carefully read your questions and would agree with your doctor on the conclusion of migraine.

Let me explain as follows:

The brain MRI (magnetic resonance imaging) has excluded any possible stroke, which would cause a permanent disability (attachments removed to protect the patient’s identity). And the EEG (electroencephalogram) has excluded possible seizures and any metabolic disorders of the brain.

On the other hand, hemiplegic migraines can cause such a clinical situation. I would suggest migraine prescription of tablet Meclizine or Dimenhydrinate for vertigo and Topiramate for secondary migraine prevention.

I hope you will find this information helpful.

Regards.