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Re: Unexplained symptoms--Long

Posted by medlib on May 28, 2000, at 8:59:35

In reply to Conversion episode !??, posted by Cynthia M on May 27, 2000, at 9:56:37

Cynthia--

I share your frustration with many of the medical community, and you seem to be afflicted by some real duds. Your daughter's symptoms (Sxs) interested me and evoked a "niggle" in the back of my mind, so I did some searching.

My best guess (and I must emphasize GUESS) is that your daughter is suffering from atypical migraines. If that *is* the case, neither of the specialist-types you mentioned is likely to be of much help (and that potential diagnosis might not occur to either of them). If your pediatrician or internist thinks it's worth investigating, perhaps they could refer you to a headache specialist.

I could blather on for pages about what I found, but I'm aware that I have an unfortunate way of sounding pedantic, pompous and/or patronizing (which is too bad, because it *isn't* the way I feel). I also have a vague recollection that someone on this board whose name starts with "C" has a medical background. (My short-term memory is the pits!)

Sorry for the personal digression. The "quick and dirty" synopsis:
--Migraines are poorly understood; thought to be a cardiovascular phenomenon in which cerebral arteries suddenly spasm shut (causing brain oxygen deprivation) which is followed by rebound vasodilation (causing pain, nausea, other symptoms). Sxs can last for days and can include profound fatigue.
--Many substances or conditions can "trigger" migraines--many individual differences. Onset can be preceded by warning signs (again, differing) and can be acompanied by usually brief, stroke-like Sxs such as visual, auditory, communication and motor disturbances.
--Migraines are connected with seratonin mechanisms and have a statistical association with other seratonin-mediated disorders like depression and PMS. They are more common in women and onset typically happens in teens--twenty.
--Both migraines and mydriasis (pupil dilation) have been reported as "infrequent" (between 1/100 to 1/1000) adverse reactions to Paxil. (We all know how inaccurate these estimations are.)

I'd be interested to know if your daughter is near or "at" her period. Also, if she is still symptomatic, if she has any reaction at all to immersing her hands in very warm water for several minutes. How does she react to sudden direct bright light (flashlight in the eyes)? Do her pupils constrict? Does she complain of increased pain? None of this is diagnostic; if her problem is migraines, her clinical presentation is not average. BTW, there are even headache-absent migraines (new to me).

If any of this sounds like a possibility to you (and you are feeling masochistic), one of the best sources of web info is the JAMA Migraine Center available from the American Medical Association homepage at www.ama-assn.org.

Good luck on unraveling your medical mystery; it's scary when something you can't understand (or get any help with) happens to your child. Odds are high that, by the time you can get in to see anyone after the holiday, whatever it is will have resolved itself. (Isn't that always the case?) If it's migraines, it *will* happen again.

Well wishes----medlib
(Wish I could learn to express myself succinctly like Noa!)


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