Some migraines can be associated with neurological symptoms such as weakness, numbness, tingling, vision and speech changes, and some strokes can be associated with headaches. Therefore, sometimes it is difficult to determine if a patient is having a migraine or a stroke, simply based on the neurological symptoms. Immediate evaluation by a medical professional, and neuroimaging, may be required.
If you have a history of chronic migraines with neurological symptoms that are 'stereotyped' (the same each time), we often recommend that you review these symptoms with a neurologist. They may be able to help you determine what constitutes common migraine symptoms for you, so you can avoid frequent visits to the emergency room.
However, if you are having new or unusual neurological symptoms, or a new severe headache, it is always best to seek immediate medical attention.