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Basilar Artery Migraine and fainting- need some advice

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Post  sconesail Sun 01 Jan 2012, 3:48 pm

Hi All,

A couple of weeks ago I was doing some reseach on the web regarding my constat fainting and migraine. I was surprised when Basilar Artery Migraine came up and fainting was listed as one of the symptoms- along with slurred speech dysrthria and a few other things I experience.

I am just wondering if the constant fainting may simply be another part of the migraine.

Here is a link
http://blog.ygoy.com/2010/01/09/basilar-artery-migraine/

I am really beginning to wonder if the constant fainting could be another manifestion of migraine. I do have slurred speech and several of the other symptoms. I would love any advice you might have. I will also talk to my neuro about this possibility

Pain free days,
sconesail

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Post  Porsche Fan Sun 01 Jan 2012, 11:41 pm

this goes back to chicken and the egg concept, however it may be simpler than that.

epileptic reaction is not syncope. syncope is a loss of oxygenated blood to the brain that causes a near or total syncopal event.

the heart and lungs/vascular system oxygenate blood. the CNS drives the electrical impulses of the heart....and the vagus nerve has a massive impact on that.

so, if you're not getting oxygenated blood to the brain, you'll faint.

i have BAM, or a BAM variant. when i have a bad syncopal event it hit's Broca's Area and I have Broca's Aphasia (i can't talk)....that's caused by an area of the brain that controls speach which doesn't get enough oxygenated blood. with my pacemaker, even in bad situations, i'm down for about 5-10 minutes vs. 50 minutes where i couldn't talk.

without some further testing....you have inconclusive drs with opinions that conflict. only steps are to rule out everything including an electrical abnormality in the heart which can cause syncope, vagus dysfunction, and even some issues with arterial and veinous blood return....thoracic outlet syndrome and bowhunter's disease. there are some easy tests called ischemic arm tests that reveal them quite quickly. CT angio is helpful. For BAM, sometimes a brain angiogram is needed to see if there are flow problems.

you have enough from Cleveland to go to your local docs and say, we haven't ruled in anything, but ruled out some. it can be a CNS dysfunction, but have an impact on the heart and it's electrical function and vascular pumping to and from the brain.

one test you really needed was heartrate variability. that test is quite helpful. at this point, i don't understand why an EP study isn't being considered.

if you're not nuts (as docs try and label tough patients), and you're not epileptic, then there aren't too many other things that cause syncope. it may have a neuro origin, but it may have a cardiac effect, thus downstream a syncopal + neurologic effect.
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Post  Cluelesskitty Sun 01 Jan 2012, 11:58 pm

Hmm, everything is possible.
BAM sounds quite plausible imo.
Marc gave you an excellent suggestions, I would do the tests he is recommending
and yes, talk to the neuro or two. I, too am curious what response will you get.


The way I understand BAM it is treated differently than other migraines.
Who knows, maybe with the right treatment you would finally stop having these
fainting spells and start having normal life!

Risa
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Post  Jewishmother Mon 02 Jan 2012, 10:42 am

I have had BAM for over 30 years now and theories have changed - first was told that they were caused by spasms of the basilar artery and now being told they are from hyperneuronal activity centered in the brain stem. There has been very little research specific to BAMs and so mostly treated same as all other migraines except for years triptans were contraindicated but now I think they are thought to be okay for BAM sufferers.

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Post  sconesail Tue 03 Jan 2012, 7:02 am

Hi All,

Thanks so much for the advice.

I know that I am grasping at straws while trying to figure this whole fainting thing out. I am not not sure it is BAM, but the fainting does seem to correlate with the headaches.

I have an appointment with my neuro later this month to discuss the findings from the Cleveland Clinic and the EEG. I will ask him about this stuff as well.

The cardiologist did recomend an MRI of the heart (which I can't do because of the stimulator) and a few other things, but that is all. Right now, there is just not a lot to be done. No one has mentioned an EP study. In Cleveland, they tried to do the heartrate variability test, but the lines kept blowing and they couldn't complete the test.

The report from the Cleveland Cardiologist pretty much ruled out Orthostatic hypotension. Unfortunately, no one seems to know what else this ccould be.

Thanks for the advice. I will keep you posted.

Pain free days,
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Post  Porsche Fan Wed 04 Jan 2012, 12:46 pm

scone,

what nerve/muscle group is your nerve stimulator supposed to work on, and where are the leads located?

let's reverse engineer this problem a bit. just a thought, that the major nerve that causes drop in pressure, changes in rhythm, and results in syncope is the vagus nerve. anyone review the stimulator and its function and or malfunction here?

just a thought.
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Post  sconesail Wed 04 Jan 2012, 2:18 pm

Hi,

I hadn't thought about the problem this way before. Thanks for the suggestion.

My stimulator leads are located just below the top of the skull. I have 2 wires- one on the left, and one on the right. Each lead has eight electrodes. I have it programmed so that it is on for 45 seconds and off for 15. (I have three programs and I can switch them around.) It seems to be working properly- when it isn't I usually know immediately because I feel the shock in a different place.

I have been wondering about the vagal nerve's role in all of this. I may see if I can get in touch with the medtronic rep so he can check things out. I do know that the fainting is better when the device is working- I learned that when I broke the leads last time. Right now, though, I think it would be reasonable to check it out. I will talk to my neuro and to my local medtronic guy about it.

Thanks.

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