HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

question-icon

History Of Migraine Since Age 31 With An Without Aura.....Tripans

default
Posted on Fri, 14 Feb 2020
Question: History of Migraine since age 31 with an without Aura.....Tripans never helped...Topamax helped but got kidney stones 2x. Used Cymbalta/Depakote pretty good but changed weight gain. Used Botox with pretty good effectiveness but new insurance did not cover. Started Tegritol shots in mid 2000's which worked sometimes to abort but not always then around 2009 started with Predisone pac which worked sometimes to abort. Used Cymbalta with Gaboppitin which worked pretty good for a while. History of mild migraines with typically longer duration....longest headache prior when I was 32 which lasted about 12 weeks daily.







My headaches have history of predominent right side of head going sometimes into temple and/or cheek bone albeit it could sometime be a bit on left, or forehead, etc.







Current headache at age 70 is now my record holder for time being daily for 13 weeks...3/4 out of 10 pain but 9 for duration; it can be there some mornings sometimes not but typically gets worse as day goes on. Tried Tegritol to abort and Predsinsone 3 dose pacs but none of these worked. I have had MRI of brain with and without contrast and MRI of cervical in mid November. Brain MRI okay...cervical shows spurs having mass effect at C 3 & C 4. You always worry about something really bad or unusual but the headache after 13 weeks in no worse and only mildly better. Currently, I am taking Cymbalta 60 mg 2x daily and 3 weeks ago began Lyrica with 150 mg 2x daily. I also started Emigality 3 months ago....no help. I also had a nerve block of some kind for cervical. I would say I'm mildly improved since Lyrica and pain block unless it took 3 months for Emagality to kick in. but very mildly improved. I'm majorly stressed directing two companies both very large working 50-60 hours a week.







Thinking about trying Botox again......whenever I've had this type of longer headache a few drs have always said migraine....most recent neurologist says migraine and cluster....although she treated for triginminal neuralgia with the Lyrica...and checked for Temporal Artheritis albeit is wasn't that.







Any ideas or solutions...sorry for rambling...
doctor
Answered by Dr. Sudhir Kumar (55 minutes later)
Brief Answer:
I agree with botox injection plan.

Detailed Answer:
Hi,

Thank you for posting your query.

I am Dr Sudhir Kumar, Neurologist, and would try my best to help you.

I have noted the clinical details and it is unfortunate to note that most treatments either failed or led to side effects. The diagnosis in your case seems to be a migraine, which has got transformed to chronic daily headaches. As per the research and guidelines, you are a candidate for botox injection therapy. Other options either may not work or would provide only partial relief from pain.

I have noted that your insurance would not cover botox, however, it needs to be taken. I do not know how much it costs in US. Wish you were in XXXXXXX I would have done botox injection therapy (with 200 units of botox) in about 700 USD.

I sincerely hope my reply has helped you.

I would be pleased to answer, if you have any follow up queries or if you require any further information.
     
Best wishes,     
Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX
For DIRECT QUERY to me: http://bit.ly/Dr-Sudhir-kumar

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
Answered by
Dr.
Dr. Sudhir Kumar

Neurologist

Practicing since :1994

Answered : 6232 Questions

premium_optimized

The User accepted the expert's answer

Share on

Get personalised answers from verified doctor in minutes across 80+ specialties

159 Doctors Online

By proceeding, I accept the Terms and Conditions

HCM Blog Instant Access to Doctors
HCM Blog Questions Answered
HCM Blog Satisfaction
History Of Migraine Since Age 31 With An Without Aura.....Tripans

Brief Answer: I agree with botox injection plan. Detailed Answer: Hi, Thank you for posting your query. I am Dr Sudhir Kumar, Neurologist, and would try my best to help you. I have noted the clinical details and it is unfortunate to note that most treatments either failed or led to side effects. The diagnosis in your case seems to be a migraine, which has got transformed to chronic daily headaches. As per the research and guidelines, you are a candidate for botox injection therapy. Other options either may not work or would provide only partial relief from pain. I have noted that your insurance would not cover botox, however, it needs to be taken. I do not know how much it costs in US. Wish you were in XXXXXXX I would have done botox injection therapy (with 200 units of botox) in about 700 USD. I sincerely hope my reply has helped you. I would be pleased to answer, if you have any follow up queries or if you require any further information. Best wishes, Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist Apollo Hospitals, XXXXXXX For DIRECT QUERY to me: http://bit.ly/Dr-Sudhir-kumar