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the difference between a stroke and a migraine?

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I am 22 years old, male and have suffered with migraines with aura since 18. I recently had an event with hemiplegic migraine/stroke symptoms where I lost the movement of my left side of my body and regained it after 15 minutes. I had my usual aura just before this event and then after had my usual migraine symptoms of painful headache and sickness. So other than my paralysis, my symptoms were identical to that of my normal migraine. I have none of the common risk factors of a stroke (high blood pressure, elevated cholesterol, etc). I have since been found to have a Patent Foramen Ovale (PFO) in my heart. My MRI at the time was found to show 2 small acute vascular events in the deep white matter adjacent to the body of the lateral ventricle of the right cerebral hemisphere had occurred. People with migraines with aura are twice as likely to have white matter lesions.Is it possible for radiologists to look at an MRI and see the difference between a stroke and a migraine?

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replied March 6th, 2016
Stroke Answer A56169
Hi! Thanks for your query on eHealth Forum!

It is often very difficult to diagnose migraine with neurological symptoms like you had based on MRI alone. The symptoms you had are more common in hemiplegic migraines. Other possibilities are benign intracranial hypertension, high blood pressure, low vitamin B12 and vitamin D, and nerve compression in the neck.

The diagnosis of hemiplegic migraines is made based on symptoms and by exclusion of above mentioned causes.

Treatment is through vitamin and electrolyte supplementation, topiramate, and non-steroidal anti-inflammatory medication. Please discuss all this with your doctor. Take care!

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