Have you seen this in migraine patients before?

Nurses General Nursing

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I responded to a thread on the Ob/gyn specialty site, but would like to ask my question in a wider forum for maximum input. I am having a major issue with migraines.

No, don't want medical advice. I've got my MD's. I just want to know if anyone has seen this before, or experienced it.

When I get a migraine (and they've been coming about every 6 days) I get outrageous autonomic system swings. There's the usual stuff (throwing up, etc.) but I have some extreme CV symptoms.

During the onset and when it's peaking my BP goes off the chart (205/110, 190/130... not making this up!) and I'm somewhat tachycardic and having arrhythmias, no angina, just a heavy feeling in my chest. (Duh!) When it keeps going up, I have to take labetolol.

THEN, I get a massive sympathetic withdrawal, within 8-12 hours... BP tanks. 60/palp, can't stand up. I try to avoid the beta blockers for this reason, but... don't want to have a blow-out with that kind of hypertension. My internist and cardiologist know about this. They just have never seen it. We are not changing my ARB because it's the right dose for me except for these episodes.

Surely I am not the only person that does this. There are almost 30 million migraine sufferers in America. And nurses see a lot of them. I'd appreciate your observations.

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Have you seen a headache specialist?

Do your doctors actually talk to each other about you, perhaps via a conference call?

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Specializes in ortho, hospice volunteer, psych,.

i don't get them. i got the short legs, slowed down metabolism, lactose intolerance, and every allergy known to womankind instead. my mom had terrible migraines with the symptoms you describe her entire adult life. i'm not much help. my mom died in 1987. a few relatives get them too. i'll check and see what they remember.

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I've never checked my vitals while having a migraine.

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Specializes in ORTHOPAEDICS-CERTIFIED SINCE 89.

My daughter has terrible migraines as does my sister.

Daughter is on Imitrex which makes her loopy. But it works. Dr tried her on all the various arb, beta and ca channel blockers which made her worse.

Finally they just went back to Imitrex and she has vicodin for the extreme ones that happen 2-3 times a year. Interesting she had a huge fibroid cyst (baby watermelon size) and after the hysterectomy she has fewer and fewer migraines . No vasovagal, or cardio sx. BP is always inthe 70/40 range. She is 43.

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Have you seen a headache specialist?

Do your doctors actually talk to each other about you, perhaps via a conference call?

Yeah... believe it or not, I'm married to a neurologist.

Ugh... this is embarrassing. I'm a PhD in physiology/pharmacology, and my husband is a neurologist, and I feel helpless. He's just mystified (I think he's using me in a study and he has an "N" of one. Me.) No one has published anything on this that I can find. It's just very, very frustrating. (You know... we all have seen sympathetic responses to pain. Mine is just a bit extreme. But when it's followed by the radical swing in the other direction????)

I don't think we can explain it here (though, there are a lot of smart people on this forum.) The membership here is huge, and the collective number of "patient-hours" represented is probably in the millions.

I was just hoping someone has seen or heard about this before.

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My daughter has terrible migraines as does my sister.

Daughter is on Imitrex which makes her loopy. But it works. Dr tried her on all the various arb, beta and ca channel blockers which made her worse.

Finally they just went back to Imitrex and she has vicodin for the extreme ones that happen 2-3 times a year. Interesting she had a huge fibroid cyst (baby watermelon size) and after the hysterectomy she has fewer and fewer migraines . No vasovagal, or cardio sx. BP is always inthe 70/40 range. She is 43.

Wow... so she has experienced hypotension, too. That's interesting.

Maybe not everyone checks their BP when they have a migraine. But what about orthostatic symptoms? Fainting? How common is that?

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Specializes in Geriatrics.

Not sure if this is what your looking for but, when my migraines hit I have all the symptoms of having a heart attack. Tightness in chest wrapping around complete chest, pains shooting down my arms, and up my jaw. But, this all starts from the right side not the left. My orders from my Dr. are to get to the nearest ER and have an EKG done each time it happens. Usually after the EKG they hit me with morphine which makes me sick to my stomach but knocks me out so when I wake the migraine is gone. These migraines are kinda rare for me, usually once a year, but I have figured out what my warning symptoms are and if I take Excedrin Migraine within the first 1/2 hour of symptom start I can stop the migraine. Why Excedrin Migraine works for me when all the prescription meds they gave me didn't is a mystery. As for my BP, it's usually low but when the pain is that bad it is high but not as high as your is.

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Abdominal Migraines with the regular type I dont know

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Not sure if this is what your looking for but, when my migraines hit I have all the symptoms of having a heart attack. Tightness in chest wrapping around complete chest, pains shooting down my arms, and up my jaw. But, this all starts from the right side not the left. My orders from my Dr. are to get to the nearest ER and have an EKG done each time it happens. Usually after the EKG they hit me with morphine which makes me sick to my stomach but knocks me out so when I wake the migraine is gone. These migraines are kinda rare for me, usually once a year, but I have figured out what my warning symptoms are and if I take Excedrin Migraine within the first 1/2 hour of symptom start I can stop the migraine. Why Excedrin Migraine works for me when all the prescription meds they gave me didn't is a mystery. As for my BP, it's usually low but when the pain is that bad it is high but not as high as your is.

That sounds autonomic (sympathetic tone) to me! For sure, they probably don't want you to take imitrex, right? One of the side effects is vasospasm (prinzemetal's angina?)

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Specializes in Geriatrics.
That sounds autonomic (sympathetic tone) to me! For sure, they probably don't want you to take imitrex, right? One of the side effects is vasospasm (prinzemetal's angina?)

They tried me on so many different types of migraine meds that i can't remember them all. I started with migraines in puberty and am now 52 and still get them. I no longer take anything except the Excedrin, I was told to take it from a 87yr old patient who suggested I take them. They work so Dr took me off everything else. Haven't taken any scripts in close to 10 years and migraines are controlled as long as I catch them early enough.

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Specializes in ortho, hospice volunteer, psych,.

one of the cousins i mentioned above, also has ms and she has been told that some of her symptoms could be either related to ms or to her migraines.

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