A recent New York Times article by Dr. Lisa Sanders is about a 51-year-old man who suffers from strange episodes of utter exhaustion for over 20 years. He would suddenly feel exhausted and weak–he couldn’t walk, stand, or even sit, and would have to lie in a dark room for hours. The next morning, he would be fine. Over the years, the infrequent episodes became monthly, then weekly, and then sometimes a couple of times a week. Over the years, he saw many doctors and had many tests but was unable to get a diagnosis to explain his exhaustion and weakness. He saw a neurologist who ruled out migraines because the exhaustion did not come with headaches. He saw a psychiatrist to rule out depression. Finally, a random comment from a colleague about migraines lead to pursuing this possibility further, but with a headache specialist. The man did have a history of migraines but had not had a migraine headache in years. Experts are aware that migraine disorder can present itself in different ways. Headaches can be preceded by or come with symptoms such as mood changes, food cravings, light or sound sensitivity, fatigue, weakness, visual changes, nausea, vomiting, dizziness, numbness or tingling, or even ringing in the ears or difficulty speaking. Yet it is possible for migraines to change over time so that migraine symptoms occur without headaches. The man was put on a migraine medication and the episodes were aborted. You can read the full article at https://www.nytimes.com/2022/03/31/magazine/acephalgic-migraine-diagnosis.html
If you have neurological symptoms, you can come to the Manhattan Center for Headache and Neurology and be evaluated by our expert providers. Take care and be well.
–Alice Wong, NP