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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Therapy For Migraines And Vertigo

Dx: Migraines: vertigo, complex - due to varying array of symptoms. Also, thunderclap ha, tension ha, (cluster ha ruled out by neurologist only based on patient classification - non-smoking 28 y/o female.) Neuro did suggest chronic pain . Hx IBS since treated with Culturelle - still has constipation w/o daily treatment. Dx: osteochondritis - specifically episodic rib spasming (posterior, axillary, to sternal - between T4-5 to T11). Depression, dx A.D.D. only 8 months ago via academic collegiate testing issues. Vertigo originally suggested due from both patient sensation of spinning and off-balance and clumsy walk and with image/vision changes/visual hallucination; Symptom: occasional mild fatigue. Tests: 1 CT and 1 open MRI in 2003 - both negative. Second MRI on T 1.0 scanner 2010 - also negative. Labs (CMP, CBC) - all normal. Medications: amytriptylline only taken at most for a week due to unrelenting fatigue and increased vertigo still noted - especially when sitting in a recliner/rocker with minimal motion; Adderall doesn t work without the current Lamictal medication (for migraines/ha) - still able to fall asleep on Adderall within 2 hrs of administration and minimal difference noted in academic ability to catch all information/ missing details. Lastly, an episode with chiropractor - ultrasound to upper back muscles causing sudden, intense, AWFUL pins/needles sensation and needed to stop after seconds - was suggested hands were on metal bars on either side of table. After that, 20 minutes later, toes of left foot fell asleep only regaining feeling 10 minutes later - then same thing with right tricep, then left bicep/shoulder, then lower thoracic/lumbar spasming adjacent to left side of spine for 10 more minutes. Probability of multiple sclerosis diagnosis vs (other neurologic/migraine issue)???
Wed, 21 Sep 2016
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  User's Response
Hello!

Thank you for asking on HCM!

I carefully passed through your question and would explain that Multiple sclerosis can be excluded as all your performed brain MRI have resulted normal.

Besides your symptomatology is not typical of multiple sclerosis.

So, relax and don't think about it any more.

I would recommend starting setraline, which can be helpful in your clinical situation in the treatment of vertigo and headaches.

You should discuss with your doctor on the above issues.

Hope to have been helpful!

Best wishes,

Dr. Aida
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Suggest Therapy For Migraines And Vertigo

Hello! Thank you for asking on HCM! I carefully passed through your question and would explain that Multiple sclerosis can be excluded as all your performed brain MRI have resulted normal. Besides your symptomatology is not typical of multiple sclerosis. So, relax and don t think about it any more. I would recommend starting setraline, which can be helpful in your clinical situation in the treatment of vertigo and headaches. You should discuss with your doctor on the above issues. Hope to have been helpful! Best wishes, Dr. Aida