Both Mays and Dr. Vernon Williams, sports neurologist and director of the Kerlan-Jobe Center for Sports Neurology and Pain Medicine in Los Angeles and a consulting team physician for the Rams, suggested Kizer may have been affected without realizing it. They described the "postdrome phase" of a migraine, where the headache is gone, but performance is still impacted.
The Browns declined a request by cleveland.com to speak to their team doctors about migraines.
"Most people say that even after the headache is successfully treated they have kind of the leftover phase,'' Mays said. "They feel like they've been run over by a semi-truck. ... There's usually some lingering symptoms that (patients) have to deal with whether it's due to the migraine or even the side effects of the medication used to treat the headache.''
Williams agreed.
"There's absenteeism -- people who can't go to work because they have a migraine -- but there's a condition that we call 'presenteeism' -- they can get there, they can be there, they can be at work, but that migraine still has an effect on their productivity, their accuracy. So it's certainly within the realm of possibility that the headache was improved or gone but there could still be some residual effect of the migraine.''
Williams noted that "after the pain is gone, there's still a period of time where the brain kind of re-establishes normalcy.''
Williams stressed that it's not difficult to differentiate between a migraine and a concussion during a game.
"Many (players) have had them for years and know what the onset is like,'' he said.
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