Another A&E thread

I would take her back in the basis of the fall and vomiting and insist on an mri. They can sedate her if you think she won’t lay still enough for it. I really hope you get answers. I know how scary things can be

I don't know how to state it more clearly. She has new progressive symptoms that are alarming (eg falls and visual changes). Furthermore the symptoms that were present when she was last seen have not resolved but are still present (worse?) several days later. These things change what management is appropriate. The advice you were given is now out of date.

She needs to be re-assessed and may need an inpatient scan for safety. Not an MRI now (unless it happens to be available), but a CT now then possibly an MRI later. This can only happen on the NHS. Call 111 today. Now. Or simply go to AE. Time to stop engaging with this thread and get a move on, in real life.

An urgent / inpatient CT will happen same or next day. At age 7 MRI is not usually done under GA, that would be exceptional. Can be arranged for days/weeks usually. Please don't go on information you get here, so much of which is wrong. Take her to be reassessed. This is my day job and I would scan her same day unless you are substantially misrepresenting her symptoms.

Look

My migraines cause pupil constriction and eye issues. I can’t see things in front of me, like pillars.I get dizzy, I vomit, I look like I have had a stroke. But I’m 47 and was scanned first.

Age 7 its probably migraine, which can mimic stroke but the NHS is broken and a scan wont be for ages. OP is right, it will need sedation (ANAESTHESIA) and this required a BIG private hospital approved for paediatrics, hard to find and a referral from a private paediatrician or NHS GP or Private GP.

This will take at least a week or two.

If more than one paediatric consultant has said wait then fine… but she needs some meds from paediatrics that’s better that simple pain killers so that’s worth AE again. Or if it’s only one paediatric consultant then it needs another’s opinion and one person can be wrong, two is more reassuring and that’s worth going in again for.

OP please help your DD get your DGD to somewhere that they will do a brain scan, it's rare but her symptoms can be the sign of a stroke or a brain injury.

I was diagnosed with something very rare and at first it was unfortunately missed and I'm still ill now and disabled because of our local hospital's mistakes and I wish I'd none back then what I know now.

Fingers crossed for you all that it's not anything serious but I always edge on the side of caution now.

I can’t sleep and have just read the whole thread.

Oh OP, you poor souls, you and your DD must be absolutely past yourselves with worry. As the mum of a 13 year old daughter who has suffered from recognisable migraines since she was 6, and she probably had them before this, I know how worrying bad headaches can be, and you have a whole lot of other symptoms added in there too. You have so much on your plate and have been through so much.

I’m afraid I don’t have any advice that hasn’t already been discussed but just wanted to offer a bit of support and a handhold.

Very true… but I have read that the OP has had some medical issues of her own, so perhaps she’s not at the moment…

The name would imply so...

@MyOtherCarIsAPorsche do you drive??

I would somehow pay for a private scan . If she needs one that should be done .btw I sympathise about your husband . Mine is on steroids for a serious autoimmune disease and his personality has changed a lot . It’s sad and difficult to live with atm .

https://www.mayoclinic.org/diseases-conditions/horner-syndrome/symptoms-causes/syc-20373547

I'm more worried that the double vision is due to a 6th cranial nerve palsy, which would urgently mandate a scan.

I would take her back to A and E and insist on a referral to neurology.
Ask to be assessed for Horner's syndrome or third nerve palsy.
At the very least she should have had a field of vision test at the opticians to rule out neurological causes.

Yeh I think your D needs to make a real big concerted effort to present at A&E with DGD no later than tomorrow morning and explain symptoms have worsened since the child was last seen and Calpol and Ibuprofen aren't touching the pain. A&E can and will give more effective pain relief but you do actually have to go there. This poor child

A&E gave me oramorph before the duty neurologist showed up. Given that I waited several hours for said neurologist and was vomiting and crying from the pain, that was a very necessary act of compassion.

I'll concede that they might not want to give triptans or ergot, but they can give a child a dose of opiates so that she can at least sleep.

Having said that, trying triptans and noting whether they worked would be useful diagnostic data, as long as it posed negligible risk to the chil

My Mum had awful migraine attacks - she would be very ill for at least a day and couldn't see properly. I had them too when I was younger. They were awful but at least I could see - though my vision was disturbed. But isn't it unusual for migraine to last for such a prolonged period?

In later years I had to call an ambulance for my Mum because she had the most horrendous headache and was crying with pain. Despite many tests and a brain scan, the hospital could find nothing untoward. Eventually, she was felt a bit better but very shortly afterwards the terrible headache returned and she was diagnosed with shingles in her head and face. I had to stay with her for a week until she began to feel better. She then developed Bell's palsy and one side of her face dropped. Fortunately, she recovered. I wondered if there was a chance that your granddaughter has shingles?

As someone else has said, if it is definitely migraine, surely there is medication to help alleviate the pain and distress? But I agree with SofiaAmes that further specialist investigation should be sought.

This may be really obvious but we have a family history of migraine down through the generations. My mother, grandmother and one of my children had them. One of the triggers for my family was chocolate. My son cut out all chocolate for a while at about 9 and the migraines went away. He can eat smallish amounts of chocolate now and we haven't had any recurrences and he seems "to have grown out of it". Of course, I realise you may have investigated all these sorts of things. I do hope your GD's situation gets resolved.

I don't understand why the hospital didn't give her a migraine medication if that's what they diagnosed.

Migraines and seizures and ASD are all very linked genetically and inheritable. My ds started getting migraines that we could recognize as that around the age of 6 or 7. He probably had them from birth. He also has cyclical vomiting. And was eventually diagnosed with mitochondrial disease (migraines are often present in mitochondrial patients). Your DGD should get an urgent referral to a neurologist (and maybe a geneticist too).
We found that taking the "mito-cocktail" of supplements helped enormously with preventing many of the symptoms including the migraines. Dr. Richard Boles is one of the experts on this. molecularmitomd.com. My ds took large doses of CoQ10, Vitamin D, B2, Levo-Carnitine, Omega 3's among other things and they all helped enormously with his migraines and general health.

You married him in sickness and in health, not in kindness and in asshole. It's not your fault either that he was under too long.

He could try CBT or some other kind of therapy for managing his thoughts and behaviour better. CBT is now available as self-directed online courses.

Her symptoms do sound most like migraine.

Edit I take it back, hadn't read the full thread but just saw she has also started falling.. her symptoms sound like brain tumour. She needs to be in hospital until she has a scan to exclude brain tumour. An MRI will not happen fast enough so likely a CT. If I saw her with these new symptoms I would admit and do a CT overnight.

(Return to post pre-edit...) she also has vomiting, vision changes and persistent/ escalating pain related to her latest acute ongoing episode. These are red flags. I'd suggest you look at some of the resources the children's brain tumour charity headsmart has produced. You can also find professionals guidelines on their website which you can share with HCPs. Nocturnal symptoms and hypertension are concerning. She needs an urgent (quite possibly inpatient) scan to be safe imo. I don't want to alarm you unnecessarily as it is much more likely this is migraine, but undiagnosed brain tumours causing raised pressure in the brain can kill suddenly (and avoidably). If she has new symptoms since last being seen go back via GP same-day or go to AE.

@MyOtherCarIsAPorsche But symptoms have worsened since then and she's still in pain, she needs adequate pain relief if nothing else!