Male late 40s with no history suddenly getting daily migraines with auras

Out of the blue, my husband had what we thought was a stroke but now believe was a migraine aura almost two weeks ago. The migraine auras have been quite significant where he is very confused, unable to speak sometimes, and not able to comprehend meaning we can't leave him alone because he is not (at least during the aura which can last 1.5-2 hours) able to take care of himself. This is followed by extremely painful headaches that leave him moaning in pain. We've been to the hospital 3 times and twice to a neurologist. He has had a series of tests and all of them so far (MRI, EEG, EKG, blood work, etc.) are clean. So we are left with daily episodes all at different times which have turned our life upside down. He takes Fiorcet and Liquid Advil when he starts to get symptoms and it seems the only thing that gives him pain relief is a Vicotin (which we naturally don't like because it is addictive). He has been prescribed Topomax and has been on that for 3 days. We see there are migraine sufferers everywhere but can't imagine life like this with every day occurrences. We have cut out virtually anything that we think could be a trigger foodwise and are trying to address things like stress, sleeping, exercise. But it seems none of that has made a bit of difference. My questions:

1. How soon could Topomax work for us at least to decrease frequency?
2. We've tried Reglan to address the pain unsuccessfully and it seems only Vicotin works. None of the over-the-counter drugs work either. Are there any other prescription pain killers that actually work?
2. Is there a particular reason you think our neurologist didn't prescribe an abortive drug (e.g. Triptans)?
3. Does anyone have experience or know of anyone who has at age 47 all of a sudden gotten daily migraines with not history of headaches or migraines?
4. I wonder whether we need to quickly get to a migraine specialist. Our neurologist seems knowledgeable and we like him. But I found it concerning that the last time we were in his office feeling a bit desperate that he prescribed us Topomax and said he's see us in 3 weeks (which feels like forever) Should we expect a little more attention with something as significant as this has been?

Of course, any other advice is welcome. We are new to all of this and quite overwhelmed by the information.

Hello, sorry for what your husband is experiencing. I can't really answer your questions, only share some of my experiences. I am 47, female and have had migraines since I was a teenager. They run in my family and the vast majority of mine are food related. Until this past year, as long as I stayed away from my triggers, I had maybe one or two a year. Cheddar cheese is my worst trigger (a guaranteed, severe M) and sometimes there would be cheddar on pizza or in food I didn't realize and I would get a bad M. My M's came with aura preceding pain and were all the same in duration, pain, everything.

For a little more than a year, I have had multiple headaches a week and they last several days. I get no aura anymore. I vomited for he first time ever twice this year. They vary in intensity, but always come with facial numbness and nausea now. I can't shake them. It's to the point I almost always have one. I was prescribed Maxalt (Triptan) a year ago and it is no longer effective. I started Topamax this week. I have not had a migraine since, but I still have a headache every day to varying degrees, and especially in the middle of the night. These are non-migraine. The only side effect I am noticing with Topamax is the tingling in my fingers. I can handle it. No confusion and no forgetting words like I read about. I am only on 25mg a day at night. Monday is my MRI, which my dr and I expect to reveal nothing. We agree my hormones are changing and my food triggers along with it. My sensitivity to tannins in food is now pretty extreme. I have tried to completely remove them from my diet.

I have asked for and received a referral to acupuncture for pain relief, I am waiting to begin that. Have not tried it for headaches, but I had it n the last for pain after a tri-mal ankle fracture and two related surgeries and it helped. I have considered hypnosis.

I am telling you about my story in hopes there might be things you can consider here for your husband. You can look at the stories of others here too. I don't get headaches as severe as some here do, but my headaches are (recently) constant. It is a somewhat sudden change for me after a life of dealing with and managing my mostly food related migraines. What I have learned is that there a TONS of triggers and we are ALL different. Caffeine is not a trigger for me. It is for others. I am extremely sensitive to perfumes and smells. Others aren't. Doctors don't fully understand this all and none of us do either. It's all trial and error. Read everything you can and don't rule anything out. Don't think the most common triggers will be your husbands triggers...his could be more obscure.

Keep a food, activity, and headache diary. Write down everything. EVERYTHING. Hopefully a pattern will emerge from something you didnt notice before. Good luck.

Jen

I'm so sorry for your husbands migraines, they are a terrible way to live. I agree with everything in the other response, especially read everything! I gained some control over my 40 years of migraines by googling migraines, research, universities. That was the beginning. I've always been under the care of headache clinics and neurologists but found my control came with my research. I bless the dr that first prescribed Zomig - my effective drug. Works only on pain in the front of my head. I still have migraines but fewer.

My control came with the following: low fat diet (migraine 3 days after fatty meal), coq10 300 mg gell caps, Petadolex, and an assortment of supplements for general health.

Good luck. Keep records and read everything. I wish your family all the best of luck.

Hi,

To start off, I have had migraines since age 12, but they became chronic at age 17. I have had only two periods of remission since then now 33.

On October 28, 1997, I was playing field hockey and the other team turned into purple sports. I motioned to the coach to pull me out and she did and I went to get migraine medicine. I never thought that my life had changed forever that day. But it did. Thant headache has never really gone away. I was first diagnosed with chronic intractable migraine, then eventually with New Daily Persistent headache.

In many ways, your husband's story sounds like New Daily Persistent Headache as it can come on at any age in people who have migraines before or not.
Here is a pretty good article that explains NDPH: NDPH Article

Unfortunately it is hard to treat. A lot of the usual treatments do not work well for NDPH and there is a lot of debate as to what to do- it is still a relatively new subcategory.
1. The only reason that triptans wouldn't be given is that either the dr thought they weren't indicated or he may have been worried about possible vascular and cardiac effects of triptans.
2. Most preventatives take that long to kick in. However, if it is not working or there are side effects- go back.
3. yes, there are other pain meds, but most drs use them as a last resort.
4. If you can get in with a specialist, great! I think it is a great idea. Make the appointment. it often takes a while to get in with the specialist, so I'd keep the local neuro in the loop as well.

good luck. I hope this helps.

Pain free days,
sailing

I just wanted to address the neurologist question in your post......I think it is always fruitful to see a migraine specialist. Usually they just confirm what your neurologist is already doing but sometimes they have different ideas. Also, your neuro has ruled out all the really evil things that could be going on and migraine is a rule-out diagnosis since there is no medical test for it. Since he has ruled out all the evil stuff he is thinking it may take 3 weeks for the topomax to kick in which is why he is waiting to schedule an appointment til then - but you should contact him sooner for help with pain control etc... if needed.

My pain is only controlled with vicodin and I am allowed 2 pills a week - I usually cut them in half - so 4 doses a week is what my doc is comfortable with for me but I know it is different with each person.

Any changes in your husband's lifestyle in the last 6 months?