hemiplegic migraine

[gawaine007]

I have been cycling with varying degrees of enthusiasm over the last ten years, I am 53.

In Trinidad over the last year I have been getting into big group rides sometimes over 60miles at 19 to 20 mph average.

Six weeks ago at home in Scotland I cycled 35 miles at 16 mph, a hilly route by myself. At the end I suffered what looked like a stroke, was taken by ambulance to A&E to be assessed for a stroke, CT scan, MRI scan .... no evidence. By the time I had been assessed I felt completely normal.

Verdict was it was an effort induced migraine..... a hemiplegic migraine.

Back in Trinidad .... back to big group cycling. Two weeks ago 74 miles at 19.9 mph was our Saturday morning ride. This weekend the ride was 55miles, usual speed but I was suffering pushing into the strong headwind on the way home. After 49 miles I lost power, and stopped. My right arm and right leg were paralysed.

After 15 minutes sitting in the support van ..... everything was good again.

Does anyone else have experience of this?

[Tangled Metal]

I have heard of exercise induced migraines. IMHO Migraines can have many triggers and perhaps certain changed exercises may be one of a few triggers. From what experts have told me you have major and minor triggers that can be next to impossible to discover. The major ones you might know (in your case exercise) but you need a mix of triggers to come along all at the same time, not always the same triggers. A couple of major triggers might be enough but you can also get a whole range of minor ones setting it off. In my sister's case it was all down to a lot of exercise (she was a dance teacher) along with low blood sugar and dehydration. Basically she was teaching in a hot studio most of the day and was not drinking enough. her glycogen stores were depleted and it all came together in a relatively mild but still debilitating migraine. She got the MRI and CT scans done (in a military hospital) and got sent home with instructions to drink orange juice regularly, well to drink something like an isotonic drink at least. She chose to drink and eat orange juice/oranges and it worked for her.

Me I get bad migraines (paralysis down one side, major visual disturbances and other aura effects along with the headaches - not a problem. Also nausea leading to vomiting - a problem as it left me so weak I could not move from the toilet. It is not a good look someone finding you slumped with your head in the toilet conscious but without the energy to move.

In my case it is poor diet on fridays that manifests if there are other triggers to a sunday migraine and a monday off work. Seriously mondays off ill is questioned, fortunately I got a mild attack at work that shocked them and they accepted the odd sick monday. When you actually see the violent vomiting I get you will know I am not faking it.

My case is not the same, is anyone with a migraine ever the same as another?? However if you are new to migraines then perhaps my advice is helpful. Eat well and regularly, little and often to prevent high and low blood sugar levels. Drink well = IME juice and water in half and half if exercising. You can buy special spoons that you can use to measure the right levels of salt and sugar into water to get the isotonic optimum to save on gatorade if you want too. Migraines may be starting days before you actually have an attack so it is a case of managing it all the time not just with an attack. Do try to go to a specialist migraine or pain clinic, they can help. Of course your GP may want to exhaust treatment first but a specialist has full access to latest knowledge, treatments and above all drugs. For example they can prescribe drugs that work better should you actually get a migraine than the GP can (in the UK at least). They can also prescribe low dose beta blockers if you get a lot of attacks or very severe ones. These are seriously heavy duty drugs that you can not stop taking without GP or doctor's help or you may end up with problems. They are supposed to be effective - I got them but never started the course due to worries about side effects and risk. Also, you may be having attacks at other times that are not strong enough for you to notice. If you get an aura with the attacks then any time you feel a bit what I call juddery (like a shiver up your spine) that comes and goes, it may be part of a mild migraine that is not affecting you much. The specialist made me realise I was actually getting a lot of attacks that I had not learnt to spot.

One more thing, if you keep a training diary of your riding along with how you felt then patterns may appear over time. Record minor ways you felt too if you can understand what I mean by that. I don't fully but things like the sunlight feeling a bit brighter than normal could be sensitivity to light or some strange smell you have that nobody else has could be an aura with your sense of smell. These could all be symptoms of a migraine, part of the aura range of symptoms that you get with the "classic" migraine.

Sorry if the above ramble went on too long. I have learnt a lot over 30 years and any migraine related thread tends to cause a bit of verbal diarrhea of advice and comments from me. just wish I could condense it more but I can't. More may come after reading other comments so I apologize now if not relevant.

[axel_knutt]

Back in Trinidad .... back to big group cycling. Two weeks ago 74 miles at 19.9 mph was our Saturday morning ride. This weekend the ride was 55miles, usual speed but I was suffering pushing into the strong headwind on the way home. After 49 miles I lost power, and stopped. My right arm and right leg were paralysed.

After 15 minutes sitting in the support van ..... everything was good again.

Does anyone else have experience of this?

Sort of. There were a couple of occasions when I got in after a days ride and found that I was struggling to sign my name at the hostel reception because my fingers were nearly paralysed. I also used to get ocular migraines, but they seem to have cleared up since I stopped cycling. I have a heart arrhythmia that predisposes me to strokes and TIAs, but I don't know whether that's what they were.

[531colin]

..............
In my case it is poor diet on fridays that manifests if there are other triggers to a sunday migraine and a monday off work................

Job stress? At one time when I had a stressful job, being woken in the wee small hours of Sunday morning by a man with a jack-hammer trying to get out of the front of my head was commonplace. I was told that a working definition of migraine could be....."that headache you get when you relax after a period of stress"......Monday to Friday stress, Saturday relax, Sunday migraine.

[Tangled Metal]

Probably a trigger but I managed to actually test out the diet on a Friday and it was a major trigger for me. Basically I could create a Sunday migraine by eating lunch after about 3:30 or 4pm on a Friday. When I changed my routine and ate an egg bun from the van on the industrial estate mid morning on a Friday then ate a proper lunch asap after I finished (usually about 3pm) the migraines stopped for a period. Well until my spring cluster (April I get hit by a cluster).

It is very rare to nail a major trigger so precisely, or it has been for me. Usually it is vague ones like red wine, chocolate. or dairy that may or may not reduce them by avoidance. My view is learn to live with them. In my case it is simple, just get into bed in a dark room and try to sleep it off. Get up to vomit occasionally as needed (well that makes me feel better for a little while once I get over the immediate tiredness anyway). My only worry is how to keep my little boy from seeing Daddy like this. Migraines have been so much a part of my life over the years that they don't bother me so much. My partner does not understand that so my new worry is making it go easier for my relatively new family.

As far as the OP goes, get fully checked out and referred to a specialist in pain or migraines. Especially if the change to your cycling is causing it. That makes it affecting your life sufficiently to warrant investigation and control.

No longer are we to accept the sleeping in a dark room or stop doing what causes it fob offs. Get them to help you. I did that (although I rejected the solution through personal choice). finally got sick of being told I was making up my symptoms because the GP's husband never got those symptoms (serious comment made by childhood GP). It is in our heads but not in the way one GP once told me. It is a condition that causes a lot of cost to the economy. Just google cost to US economy of migraine and you will see huge figures. In the UK it is similar sorts of levels. Talking NHS shortfall levels I think (billions not millions).