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Indeed, in the case I'm dealing with the chap was left with a permanent homonymous quandrantonopia, with the scotoma being similar to his usual visual aura. Although there was macular sparing I imagine it must be quite disabling, but very rare I suspect. AF ----- Original Message ----- From: <[log in to unmask]> To: "Adrian Fogarty" <[log in to unmask]>; <[log in to unmask]> Sent: Monday, July 31, 2006 10:44 PM Subject: Re: Re: Migraine/Triptan therapy Saw a lad of 12 two weeks ago with hemiplegic migraine that lasts up to 9 days. It was his third episode when I saw him. Surely he is going to stroke out one day poor lad. Some fancy MRI flow study is needed or some such clever stuff. APV Scarfborough Thanks Vic! > >Has anyone seen or heard of significant complications arising as a result >of >untreated migraine? I'm thinking in particular of migrainous infarction but >it must be rare as hen's teeth (and I see most of the literature out there >groups migraine in with all the other "benign" causes of headache). Don't >suppose there's any evidence surrounding prevention of such complications >either although one might argue that triptans should in theory be more >specific at aborting the vasospasm. > >AF > >----- Original Message ----- >From: "Vic" <[log in to unmask]> >To: <[log in to unmask]> >Sent: Friday, July 28, 2006 7:55 PM >Subject: Re: Migraine/Triptan therapy > >I suffer from Migraine occasionally and make sure I carry a triptan around >in the car, in my bag, at home, and on holiday. I find I have 20 minutes >from the start of the right inferotemporal scintillating scotoma to the >onset of the headache and a triptan aborts it completely if taken at that >stage. Now I know lots of people react differently so this is just personal >experience but I know it has helped others. > >I really suffered as a kid, but basically I was bullied by big brother >(some >of you know him - he's in medicine too). My migraines resolved largely when >I realised at the age of seven that I could win the fight if I kicked him >in >the gonads (Stress relief, empowerment etc). I started with migraines again >as a GP, then read the label of this new Red Bull drink I'd taken a fancy >to. Then a few years ago I started having daily migraines. I was actually >having one when a young lad came in with his mother. He was getting >migraines too. Mum asked if I had a list of things he shouldn't eat and I >went on Google to find one. I found this >http://altmedicine.about.com/od/popularhealthdiets/a/migrainediet.htm >I had started having banana smoothies for breakfast. If I don't have more >than three bananas a week I'm fine. I've given the printout to hundreds of >patients now and they almost all report that the migraines get a lot less >frequent. As for the others - they just have to learn to kick the bugger in >the balls! > >Vic Calland > >-----Original Message----- >From: Accident and Emergency Academic List >[mailto:[log in to unmask]] On Behalf Of Adrian Fogarty >Sent: 28 July 2006 07:47 >To: [log in to unmask] >Subject: Migraine/Triptan therapy > >What is the accepted wisdom on the management of acute migraine these days? >Do most people stick with the tried-and-tested methods of analgesia, >anti-emetics and fluids? Or do many of you now use triptans, and if so, in >which particular patients or perhaps as a routine? Am finding it very >difficult to find any good evidence or consensus on this particular >question. Any advice gratefully received. > >AF >