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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Chronic Migraine, Had Projectile Vomiting As An Infant, Have Frequent Headaches, Occasional Migraine. Brain Tumor Ruled Out, Advised Depression Medicines. Suggestive Treatment?

I was diagnosed with migraines when I was 6 years old but have had them since I was born. I am told that when I was an infant it was every other day or so that I would projectile vomit, etc. I continued to have the symptoms/headaches (when i was older) at least once a week until about the time that I was 6 or so. As I grew they became less frequent spacing to about once a month in middle school, then about every 6 months in high school. I have been in college for the last 6 years since I graduated high school making me 24 years old. I thought I was doing a lot better but over the last 3 years or so they have become much more frequent. I am scared by my headaches because the medications I have tried for them (such as Imitrex ) never really made any difference and they feel different than how I have heard other people describe migraines though they seem close to textbook definitions. I know many of these symptoms are classic but here are my main characteristics: I have an aura before they happen when can be even hours in advance, I tend more commonly have them in the evenings, I have very sensitive to light and noise, I can always hear and feel my pulse in my forehead , the pain is more generalized then isolated to a specific spot, I am nauseous and will repeatedly vomit; if I try to have anything that day including sucking on an ice cube it will usually trigger the vomiting again. When I was about 6 years old my mom tried everything but nothing that she could find helped; I was also tested to see if I was actually having seizures rather than headaches. My mother told me that they said the EEG was not normal but that I was not having seizures. These last couple of years I have been getting many frequent headaches, but I still only get a migraine every few months. I also have a sensation similar to that of being dizzy when you stand up to fast at random times that do not make sense and frequently see stars. I had a spell in 2009 that was bad enough that I went to the emergency room for it, they gave me an saline (?) IV and did a CT scan of my brain to check for a tumor , the screen came back clean and my final diagnosis was symptoms are unexplainable; patient denies drug use. They did test which all came back clean and I do not do drugs so I am unsure why this was the final statement. I have talked to many doctors but never been referred to a specialist or a neurologist or anything. Since I don t currently have insurance ( I am working toward being able to purchase) I was wondering if you may have any suggestions of who to talk to next rather than paying for a visit to be referred somewhere else or be told the same thing I have been told for so many years usually being to deal with it or try other migraine meds. I was once recommending being put on a depression medication to control the headaches but have not tried this as this recommendation was given when I was doing well and it seemed like a lot of potential drug side affects for an unsure outcome.
Mon, 26 May 2014
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Neurologist 's  Response
Hi,

Thank you for posting your query.

I have noted your symptoms. Thank you for being so descriptive, it helped.

In my opinion, the symptoms are typical of migraine with aura. There could be variations in symptoms of different people.

You should be on prophylactic treatment for migraine, so that we can prevent these episodes in future. The best medications for that would be either Topiramate or divalproex tablets.

For relief of symptoms, you can take ritzatriptan tablets or vasograin tablets.

You should see a neurologist, and probably repeat an EEG and get your brain MRI done to exclude other possibilities such as seizures.

I hope it helps.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Senior Consultant neurologist
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Chronic Migraine, Had Projectile Vomiting As An Infant, Have Frequent Headaches, Occasional Migraine. Brain Tumor Ruled Out, Advised Depression Medicines. Suggestive Treatment?

Hi, Thank you for posting your query. I have noted your symptoms. Thank you for being so descriptive, it helped. In my opinion, the symptoms are typical of migraine with aura. There could be variations in symptoms of different people. You should be on prophylactic treatment for migraine, so that we can prevent these episodes in future. The best medications for that would be either Topiramate or divalproex tablets. For relief of symptoms, you can take ritzatriptan tablets or vasograin tablets. You should see a neurologist, and probably repeat an EEG and get your brain MRI done to exclude other possibilities such as seizures. I hope it helps. Best wishes, Dr Sudhir Kumar MD DM (Neurology) Senior Consultant neurologist